Table of Content

10 February 2017, Volume 25 Issue 2

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A case-control study on the MMP-8C-799T and susceptibility to spontaneous preterm birth and premature rupture of membranes

YANG Xiao,PENG Wei,ZHU Li-na,ZHANG Xiao-ai,WANG Yan

2017, 25(2):  112-116.  DOI: 10.11852/zgetbjzz2017-25-02-02

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Objective To investigate the association between the genetic polymorphisms of MMP-8C-799T and susceptibility to spontaneous preterm birth (SPTB). Methods This case-control study enrolled 753 SPTB singleton neonates and 681 term neonates.Polymorphism was genotyped using Sequenom MassARRAY SNP. Result Compared with the CC genotypes,MMP-8-799T-positive genotypes (CT+TT genotypes) were significantly associated with a decreased susceptibility to SPTB and moderate SPTB.The -799T-positive genotypes (CT+TT genotype) were also significantly associated with decreased SPTB susceptibility in preterm neonates with PROM.Comparing with the CC + CT genotypes,-799TT genotype was marginally associated with a decreased SPTB susceptibility in preterm neonates without PROM. Conclusion MMP-8C-799T contributes to the SPTB susceptibility.

Genetic analysis on SLC25A13 gene in children with neonatal intrahepatic cholestasis caused by citrin deficiency

BAI Xin-li,ZHANG Ya-nan,WANG Xiao-kang,ZHANG Hui-feng,LI Ying-chao

2017, 25(2):  117-120.  DOI: 10.11852/zgetbjzz2017-25-02-03

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Objective To investigate genetic features of SLC25A13 gene with neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD). Methods Genomic DNA was extracted from peripheral blood leukocytes in 42 patients with idiopathic cholestasis.Polymerase chain reaction,direct sequencing and genetic analysis were performed using specific primers from 18 exons of SLC25A13 gene. Results 7 patients were diagnosed with NICCD,of which two patients were homozygous 851del4 mutation:c.851_854delGTAT (p.Met284fs) / c.851_854delGTAT (p.Met284fs).Other five patients were compound heterozygous mutations:c.851_854delGTAT (p.Met284fs) / c.754G>A (p.Glu252Lys);g.IVS11+1G>A /g.IVS16ins3kb;c.851_854delGTAT (p.Met284fs) / g.IVS6+5G>A; c.G1064G>A (p.Arg355Gln) / c.G1157G>T (p.Gly386Val); c.1078C>T (p.Arg360Term) / c.IVS4+6A>G. Conclusion c.851_854delGTAT (p.Met284fs) are detected in 6 out of 14 SLC25A13 gene mutant alleles,with a mutation rate of 42.8% (6/14) in 7 patients with NICCD.It is the major mutation (42.8%) in SLC25A13 gene with NICCD patients.Genetic analysis for SLC25A13 gene are helpful to the diagnoses of NICCD.   

The relationship between the neonatal hyperbilirubinemia and Gly71Arg's genetic polymorphisms of UGT1A1 in Uygur and Han nationalities in Xinjiang

LI Shu-fen,Ayixianmu,WANG Ran,GU Xiao-li,LI Xue-xiang

2017, 25(2):  121-123.  DOI: 10.11852/zgetbjzz2017-25-02-04

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Objectives To investigate the relationship between neonatal hyperbilirubinemia in different nationalities and the types of gene mutation of exon l of bilirubin uridinediphosphate-glucuronosyltransferase (UGT1A1). Methods Total of 54 cases with unexplained neonatal hyperbilirubinemia and 54 neonates without neonatal hyperbilirubinemia were included.The genotypes in Gly71Arg site of UGT1A1 gene were determined by Polymerase Chain Reaction (PCR),Gel electrophoresis,and gene sequencing.Then differences between case group and control group were compared statistically. Results The Results of Hardy-Weinberg genetic balance test showed that observations and expectation values of Gly71Arg were goodness of fit in case group and control group of Uyghur and Han,which indicated that the research population was in a state of genetic equilibrium.The allele frequency of Gly71Arg mutation in the case group of Uyghur was significantly higher than that in the control group (P<0.05).But there was not significant difference in Han.Besides,the result revealed that the Gly71Arg allele carriers (A/G,A/A + A/G) were associated with the increased risk of neonatal hyperbilirubinemia when compared with the G/G allele carriers in Uyghur (OR=2.556,95%CI=1.159~5.640;OR=2.671,95%CI=1.228~5.813).But there was no significant difference between Uyghur and Han. Conclusions The Gly71Arg mutation of UGT1A1 gene is associated with hyperbilirubinemia of neonatal in Xinjiang,and it will increase the risk of neonatal hyperbilirubinemia.At the same time,it may be more frequently found among Uyghur newborns.So there may be some nationality specificity,which is valuable to deeply study.   

Correlation study on newborn cord blood 25(OH)D and IgE levels

WU Can-kui,XIA Yu,CAO Yuan-bao,JI Ru-feng,FU Bin,SUN Peng-ling

2017, 25(2):  124-127.  DOI: 10.11852/zgetbjzz2017-25-02-05

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Objective To study the correlation of newborn cord blood 25(OH)D and total IgE levels. Method Cord blood 25(OH)D and total IgE levels were measured in 185 newborns.The health status of pregnant women and history of newborn birth were recorded by questionnaires;The status of offspring allergy was evaluated at approximately 1 year. Results The average and median value of 25(OH)D levels were (49.63±16.56) nmol/L and 49.50nmol/L;The average value of IgE level was (513.85±116.54) U/L;38 infants experienced allergy at follow-up;Cord blood 25(OH)D level in allergic infants was (38.88±12.33) nmol/L,and (52.41±16.41) nmol/L in non-allergic infants,there was significant difference between them (P<0.05);Cord blood total IgE level in allergic infants was higher than non-allergic infants (P<0.05);Family history of allergy and cord blood 25(OH)D level had association with cord blood total IgE level by Univariate analysis;Cord blood 25(OH)D level was inversely associated with total IgE level (r²=0.576,P<0.05). Conclusion Cord blood 25(OH)D level has an negative association with total IgE and reduced vitamin D level in cord blood would be a risk factor for the development of allergy in the first year of life.   

Study on the growth and development of premature infant with different milk formula feeding

LIU Li-fang,CHEN Hong-jie,TIAN Qing,ZHANG Sheng-rong,LI Xiao-dong

2017, 25(2):  128-130.  DOI: 10.11852/zgetbjzz2017-25-02-06

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Objective To explore the effects of different milk feeding pattern on the growth and development of preterm infants. Method 247 cases of 800~1 500 g preterm infants from Jan.2011 to Dec.2015 were divided into mother breast milk group 78 cases (group A),the mother breast milk + human milk fortifier (HMF) 75 cases (group B),without mother breast milk accepting donor breast milk + HMF group 49 cases (group C) and without mother breast milk accepting the premature formula group 45 cases (group D).All infants were taken active feeding measures,with observation of full enteral feeding,physical growth and development,complications,the average length of hospital stay,etc. Results Mother breast milk group were lower than other three groups in physical development indexes such as the head circumference,weight and body length,time to enteral feeding at 100 Cal/(kg·d),regain birth weight time,while venous nutrition time was longer than other groups (P<0.05).There was no statistically significant difference between the other three groups.Preterm formula group had higher risk of infection within 1 year after discharge than other groups (P<0.05).There was no statistically significant difference in incidence of cholestasis,length of hospital stay,feeding intolerance and incidence of EUGR between the four groups (P>0.05). Conclusion The preterm birth mother milk + HMF is the best milk feeding pattern for preterm infants,followed by donor breast milk + HMF and preterm formula.   

Behaviors and factors affecting sun exposure among elementary and middle school students in Shenyang city

GAO Qian,WANG Xue,LIU Yang,WANG Fang

2017, 25(2):  131-134.  DOI: 10.11852/zgetbjzz2017-25-02-07

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Objective To know the behaviors and factors affecting sun exposure among elementary and middle school students in Shenyang city in order to give reference to school health education. Methods Totally 1 689 students from four elementary and middle schools in Shenyang were surveyed by self-developed questionnaire to explore their behaviors and factors affecting sun exposure.The score of sun exposure behavior was calculated. Results The score of sun exposure behavior was the lowest among middle school girls (27.21±5.47),and it was the highest among elementary school boys and middle school boys (30.15±5.33 and 30.17±5.75,respectively).The outdoor time of students on the non-school day during the summer was the longest,and it was the shortest on the school day during the non-summer seasons 31.5% students believed that academic stress was the main reason to hinder their outdoor activity and 12.2% believed poor air quality. Conclusions Elementary and middle school students have less sun exposure on the school day during non-summer seasons than during other time of the year.The main reasons which hinder students from outdoor activities are high academic stress and poor environmental quality.   

Effects of lithium chloride on the activity of PI3K/Akt signaling pathway in hypoxic neural stem cells

CHEN Chang-chun,ZHOU Qin,YAN Yan,WANG Qi,ZHANG Xiao-yuan,YIN Xiao-juan

2017, 25(2):  135-138.  DOI: 10.11852/zgetbjzz2017-25-02-08

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Objective To investigate the effect of lithium chloride on PI3K/Akt signaling pathway in hypoxic neural stem cells (NSCs). Methods The models of hypoxic NSCs were established by culturing and identify NSCs isolated from neonatal SD rat.The NSCs of normal control group was cultured in serum-free medium.The culture medium of normal saline intervention group was immediately added normal saline,and lithium chloride intervention group was immediately added different concentration of lithium chloride.Akt /P-Akt signaling pathway markers of NSCs were detected by immunohistochemistry. Results The amount of NSCs decreased and the characteristics of the NSCs was abnormal in shape,such as low refraction,swollen perikarya or even membranolysis.The number of dead cells of NSCs in hypoxic group increased significantly (P<0.05).The activeness of NSCs in hypoxic group decreased significantly (P<0.05).Compared with hypoxic group,normal saline intervention group and 5 mM lithium chloride intervention group,P-Akt expression level of hypoxic NSCs in 1 mM lithium chloride intervention group increased significantly,while decreased significantly compared with 3 mM lithium chloride intervention group.Compared with 1 mM and 5 mM lithium chloride intervention group,P-Akt expression level of hypoxic NSCs in 3 mM lithium chloride intervention group increased significantly.Compared with other groups,the number of hypoxic NSCs positive expressing P-Akt in 3 mM lithium chloride group increased significantly (P<0.05). Conclusions Lithium chloride activates PI3K/Akt signaling pathway in hypoxic NSCs.   

Effects of budesonide on airway remodeling through regulating the expression of ORMDL3 and MMP-9 in chronic asthma mouse model

YU Jia-chen,YU Fei,SUN Yan

2017, 25(2):  139-142.  DOI: 10.11852/zgetbjzz2017-25-02-09

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Objective To investigate the effect of budesonide on the expression of orosomucoid1-like3(ORMDL3),matrix metalloproteinases-9(MMP-9) and understand the mechanism of budesonide in inhibition of airway remodeling in chronic asthma mice. Method Mice were divided into three groups,including the asthmatic model group,the budesonide group and the control group.The asthmatic model were established by administrating OVA and aluminum hydroxide.The BUD group were administered with aerosol budesonide (100 μg/kg) before OVA challenge from day 21.The control group were sensitized and challenged with PBS instead.Using HE staining and Masson staining to assess the extent of bronchial inflammation and collagen deposition in each group.The expression of ORMDL3 and MMP-9 were examined in absence and presence of treatment via immunohistochemistry,RT-PCR and Western blotting in 12 weeks. Results The asthma group showed more inflammatory responses and airway remodeling compared with the control group and the BUD group.Administration of BUD decreased the severity of pathological changes but not eliminated these changes.Data proved that both ORMDL3 and MMP-9 increased significantly in asthma group while increased slightly in BUD group.Besides,the increase of ORMDL3 had a significant correlation with MMP-9 level.And content of ORMDL3,MMP-9 had positive correlation with the thickness of airway. Conclusion Administration of BUD may down-regulate the expression of ORMDL3 and MMP-9 to reduce airway remodeling.

Research on metabolic disorder of maple syrup urine disease

SONG Dong-po,LI Wen-jie

2017, 25(2):  143-146.  DOI: 10.11852/zgetbjzz2017-25-02-10

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Maple syrup urine disease (MSUD) is an inherited disorder of branched chain amino acids and their derivatives including alpha ketoisocaproic acid (KICA),alpha-ketoisovaleric acid (KI-VA) and so on.The disorder inhibits indirectly the catabolism of alpha-hydroxy acids and Results in immense deposits of alpha hydroxy butyrate and a hydroxyl isovalerate in patient's urine and sweat which give rise to the classic "maple syrup" or burnt sugar smell.Acute elevations of branched chain amino acids and their derivatives cause metabolic encephalopathy,if no timely treatment of maple syrup urine disease will lead to seizures,coma and even death.The pathogenesis,clinical diagnosis and treatment of MSUD are reviewed in this paper.   

Progresses of clinical diagnosis and therapy in methylmalonic academia

SUN Ying-mei,LI Wen-jie

2017, 25(2):  147-150.  DOI: 10.11852/zgetbjzz2017-25-02-11

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Methylmalonic acidosis is the most common disease of congenital organic acid metabolic disorders,and it is an autosomal recessive disease.The cinical manifestations of Methylmalonic acidosis is no specific.It is characterized by feeding difficulties,recurrent vomiting and the neurological symptoms such as lethargy,convulsion,movement disorders,and so on.Diagnosis of the disease depends on the measurement of acylcarnitines in the blood by tandem mass spectrometry and the detection of methylmalonic acid in the urine by gas-chromatography mass spectrometry.The vitamin B₁₂-responsive patients with methylmalonic acidemia and homocystinuria should be mainly treated with vitamin B₁₂,L-carnitine and betaine,while the vitamin B₁₂-nonresponsive patients should be treated with protein restriction,the special milk formula without isoleucine,valine,threonine and methionine,as well as the L-carnitine.Compared with the vitamin B₁₂-nonresponsive patients,the vitamin B₁₂-responsive ones have better outcome.   

Advances in research on children's exposure to air pollution and CC16

SHI Hang,ZHU Yun,LV Xue-feng,HE Qin-cheng,MA Ya-nan

2017, 25(2):  151-153.  DOI: 10.11852/zgetbjzz2017-25-02-12

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With the rapid development of modern society,a series of respiratory diseases caused by air pollution have been widely concerned.Clara cell secretory protein (CC16),a biomarker of lung disease,is mainly produced by the secretion of Clara cells in the respiratory tract.In recent years,the study show that indoor and outdoor air pollution exposure may affect the level of CC16,but the specific mechanism is not completely clear.In this paper,the relationship between indoor and outdoor air pollution exposure and children's CC16 and the mechanism of the effect of air pollution on CC16 are reviewed in detail.   

Movement recognition technology in preterm infants

WANG Yu-qing,ZHU Ping,GU Gui-xiong

2017, 25(2):  154-157.  DOI: 10.11852/zgetbjzz2017-25-02-13

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Preterm birth is associated with increased risks of neurological and motor impairments.The risks are highest in those born at the lowest gestations.Early identification of those most at risk is challenging meaning that a critical window of opportunity to improve outcomes through therapy-based interventions may be missed.Clinically,the assessment of spontaneous general movements is an important tool,which can be used for the prediction of movement impairments in high risk infants.Movement recognition aims to capture and analyze relevant limb movements through computerized approaches focusing on continuous,objective,and quantitative assessment.Different Methods of recording and analyzing infant movements have recently been explored in high risk infants.These range from camera-based solutions to body-worn miniaturized movement sensors used to record continuous time-series data that represent the dynamics of limb movements.This analysis has focused on the detection and classification of atypical spontaneous general movements.This article aims to identify recent translational studies using movement recognition technology as a Method of assessing movement in high risk infants.The application of this technology within pediatric practice represents a growing area of inter-disciplinary collaboration,which may lead to a greater understanding of the development of the nervous system in infants at high risk of motor impairment.   

Early prediction and drug therapy of capillary leak syndrome in newborn

SHENG Li-juan,HUANG Wei-min

2017, 25(2):  158-160.  DOI: 10.11852/zgetbjzz2017-25-02-14

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Capillary leak syndrome (CLS) is one of the common critical cases in NICU.Capillary leak syndrome has high mortality and complex clinical manifestation.It is often neglected due to other complications.Currently,there is no uniform diagnostic criteria.The diagnosis mainly base on clinical manifestation and laboratory examination.The therapeutic principles mainly include controlling the primary disease and fluid resuscitation.Common drugs include antibiotics,hydroxyethyl starch,albumin,blood products,vasoactive agent and so on.Understanding the pathogenesis and clinical manifestations and giving early intervention may improve the survival rate and prognosis of newborns with CLS.   

Effect of strengthening of breastfeeding on the prevention of infection in very low birth weight infants

ZHANG Li-xia,CHEN Yong-tao,FU Yin,DAI Yi-heng,GAO Ping-ming

2017, 25(2):  161-163.  DOI: 10.11852/zgetbjzz2017-25-02-15

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Objective To investigate the effect of strengthening of breastfeeding on the prevention of infection in very low birth weight infants. Methods 80 preterm infants whose birth weight between 1 000 g and 1 500 g were involved in this study.According to the feeding mode,the infants were divided into two groups.The reinforcement of breastfeeding group (experimental group,n=40,The proportion of breast milk during hospitalization accounted for more than 75% of the total feeding,breast milk was from the children's own mother.When the feeding amount was more than 80 ml/ (kg·d),human milk fortifier was added).Formula milk feeding group (control group,n=40,all preterm infants were fed with formula during hospitalization).The time of reaching total enteral feeding,feeding intolerance,nosocomial infection,and the incidence rate of neonatal necrotizing enterocolitisin of the two groups were compared. Results Two groups had no diffences in gestational age or gender or birth weight(P>0.05).The time of reaching total enteral feeding of experimental group was(15.22±4.37)d,while the control group was (17.38±5.44)d.Statistically significant difference was demonstrated in time of reaching total enteral feeding between the two groups(P<0.05).The cases of feeding intolerance in the experimental group were 7,and in the control group were 15,statistically significant difference was demonstrated in feeding intolerance between the two groups(P<0.05).The nosocomial infection cases in the experimental group were 2,and in the control group were 7,statistically significant difference was demonstrated in nosocomial infection between the two groups(P<0.05).The incidence rate of neonatal necrotizing enterocolitis of the two groups had no significant differences (P>0.05). Conclusions Strengthening of breastfeeding in very low birth weight infants can shorten the time of reaching total enteral feeding,decrease the incidence of feeding intolerance and nosocomial infection,meanwhile do not influence the occurrence of neonatal necrotizing enterocolitis.   

Diagnostic value of NBNA score combined head MRI in the neonates with severe hyperbilirubinemia for brain injury

ZHANG Hai-yan,QIAO Lin-xia,ZHU Wen-ying,WANG hua

2017, 25(2):  164-166.  DOI: 10.11852/zgetbjzz2017-25-02-16

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Objectives To investigate the diagnostic value of neonatal behavioral neurological assessment (NBNA) and magnetic resonance image (MRI) in the newborns' brain injury with severe hyperbilirubinemia. Methods 20 cases of newborns with severe hyperbilirubinemia brain injury were admitted between Sep.2013 and Sep.2015 as the research objects.MRI result was further analysised after using NBNA score and MRI.The control group (n=20) who were normal newborns accepted the examination of NBNA.Subsequently,the NBNA scores of the two groups was analysised.The infants with MRI signal abnormality were rechecked at the age of 6 months. Results The NBNA scores of research objects were significantly lower than that of control group.In the 20 cases,9 cases with MRI signal abnormality and 11 cases without any pallidum signal changing.The NBNA scores of the abnormal MRI group were lower than that of the normal group.And there were no abnormal signals when recheck in their 6 month. Conclusions MRI scans is particularly important during the diagnosis of the newborns' brain injury.The NBNA score and head MRI can be used as the index of early diagnosis for brain injury in newborns.

Application of early intervention in very low birth weight infants treated in neonatal intensive care unit

GU Li,ZHONG Yue,LI Shuang-shuang,ZHOU Jin-jun

2017, 25(2):  167-169.  DOI: 10.11852/zgetbjzz2017-25-02-17

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Objective To investigate the significance of early intervention in very low birth weight infants (VLBWI) treated in neonatal intensive care unit (NICU). Methods The hospital dates of 81 VLBWI from January 2014 to October 2015 were divided into two groups,intervention group (40 cases) and the control group (41 cases).In the intervention group,infants were nursed through NIDCAP and intervened by training of stimulation and physical before their discharge.Their parents learned the intervention measure by the Wechat group and the school about premature.The follow-up were performed by telephone once a week after their discharge.In control group,infants were nursed with the routine intervention and followed up.At 44 weeks gestational age,the indicator of their physical development and GMs were investigated and compared. Results At 44 weeks gestational age,there was no significant difference (P<0.05) in weight and length;No statistically significant was found in head circumference.Comparing the GMs of the two groups,the intervention group had higher occurrence of normal general movements (33 cases vs.22cases).In contrast,the intervention group had lower occurrence of poor repertoire general movements (5 cases vs.12 cases) and cramped-synchronized general movements (2 cases vs.7cases).The difference was statistically significant (P<0.05). Conclusions In NICU,early intervention in VLBWI can improve the prognosis of VLBWI.   

Analysis of risk factors for preterm birth in Xuhui district of Shanghai from 2006 to 2012

WANG Fei,KAN Hai-dong,GU Hai-yan,CHEN Ren-jie,GUO Feng-xia,MA Wen-juan

2017, 25(2):  170-173.  DOI: 10.11852/zgetbjzz2017-25-02-18

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Objectives To analyze the risk factors for preterm birth in Xuhui district. Methods The information of all infants who were born in Xuhui district hospitals in Shanghai from January 1,2006 to December 31,2012 were collected.According to the case-control study,the risk factors for preterm newborns were analyzed using univariate unconditional Logistic regression analysis and multivariate unconditional Logistic regression analysis. Results A total of 38 585 births were included from 2006 to 2012.The incidence of preterm birth was 5.81%.One-factor unconditional Logistic regression suggested birth defects,gestation,parity,production times,maternal age,and paternal age as possible risk factorS for preterm delivery.Finally,the step forward Method of multiple unconditional Logistic regression were used.The result turned out to be significant for the factors of maternal age,birth defects,and number of child,with the respective odds rations of 1.041(95%CI:1.029~1.054),2.362 (95%CI:1.621~3.442),31.325(95%CI:27.200~36.074). Conclusion Maternal age,multiple births and birth defects will increase the risk of preterm birth.   

The correlation of maternal-neonatal vitamin D and it's influencing factors in Shuimogou district of Urumqi City

LI Xue-xiang,FENG Chang-song,Zuorihan·Aysia,LI Shu-fen

2017, 25(2):  174-176.  DOI: 10.11852/zgetbjzz2017-25-02-19

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Objective To investigate the correlation between neonatal and maternal vitamin D levels and to explore the influencing factors of neonatal umbilical cord blood levels of vitamin D. Methods From November 2015 to March 2016 winter,umbilical venous blood samples were collected from 112 full-term neonates,and venous blood samples were collected from 40 mothers.ELISA was applied to measure the serum 25(OH)D levels and correlative factor analysis was performed. Results The levels of serum 25(OH)D were (6.75±3.59) ng/ml in 112 neonates,vitamin D deficience state was shown in all the neonates.Neonates with moderate and severe vitamin D deficiency accounted for 85.7%.Maternal 25(OH)D levels were positively correlated with neonatal vitamin D levels (r=0.86,P<0.01).The nationality of pregnant women,calcium supplementation during pregnancy,the number of seafood intake,the degree of education and neonatal vitamin D levels were significantly different (P＜0.05).Pregnant women with different gestational weeks,job categories,outdoor activity time,cramps or not during pregnancy and neonatal birth time,the sex of the fetus,birth Methods have no significant difference with neonatal vitamin D levels (P>0.05). Conclusions Vitamin D deficiency is severe among the neonates born in winter,and the level of vitamin D is significantly correlated with the venous blood of the late pregnant women.Pregnant women should be given adequate vitamin D in the third trimester of pregnancy,especially in winter,in order to increase the level of vitamin D in newborn infants.

Analysis on two misdiagnosis cases of neonatal Prader-Willi syndrome

QIU Qi-zhou,CHENG Gui-hui,CHEN Hong-yu,XIAO Yi,HUANG Ling-yan

2017, 25(2):  177-179.  DOI: 10.11852/zgetbjzz2017-25-02-20

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Objective Two misdiagnosis cases with neonatal Prader -Willi syndrome(PWS)were analyzed,in order to early diagnosis and reduce misdiagnosis or missed diagnosis. Methods The clinical manifestation and diagnosis of 2 cases with PWS were analyzed retrospectively from June 2009 to June 2016.The clinical features and misdiagnosis reasons were summarized Results Two cases of PWS described in this study had some features such as decreased fetal movement,hypotonia,poor response,feeding difficulty,less crying and doing,special appearances and cryptorchidism,Testing their chromosome 15 q11.2 belt in the middle part missing with methylation specific multiplex ligation dependent probe amplification (MS-MLPA) Method can diagnose PWS. Conclusion The clinical manifestations of neonatal PWS is not typical.It is easy to result in misdiagnosis or missed diagnosis.Improving cognition of the disease can reduce misdiagnosis.The children with poor muscle tone,feeding difficulties and special features,genetic analysis is needed in time for early diagnosis.   

Detection and significance of plasma D-dimer in early neonatal common diseases

FU Shu-fang,XU Zhi-liang

2017, 25(2):  180-182.  DOI: 10.11852/zgetbjzz2017-25-02-21

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Objective To investigate the clinical significance of plasma D-dimer level in early neonatal common diseases. Methods Venous blood samples were collected from 300 cases of neonatal common diseases (experimental group) and 50 cases of healthy newborns (control group).The level of D-dimer was tested by ELISA. Results Compare with the healthy control group (320.4±145.5),D-dimer levels of mild (1 167.5±683.7) and severe (5 399.5±3 123.3) neonatal asphyxia groups were both significantly increased,especially in severe neonatal asphyxia group.Compared with healthy control group (320.4±145.5),the D-dimer levels of neonatal pneumonia group (2 406.8±1 559.5) significantly increased.The D-dimer levels of neonatal respiratory distress syndrome (NRDS) group (1 975.6±1 205.66) and neonatal jaundice group (401.13±229.15) significantly increased compared with healthy control group (320.44±145.58),while neonatal wet lung disease group (316.92±174.29) had no statistically significant difference. Conclusion The plasma D-dimer testing has some practical value for diagnosis and prognosis of newborns hypercoagulable state and thrombotic disease.   

The analysis of risk factors associated with hypoxic-schemic encephalopathy among neonates of elderly parturient women

XIAN Li-rong

2017, 25(2):  183-186.  DOI: 10.11852/zgetbjzz2017-25-02-22

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Objective To explore risk factors associate with hypoxic-schemic encephalopathy (HIE) and preventive strategies among neonates of elderly parturient women. Methods From January 2010 to June 2016,a total of 128 case of elderly parturient women were selected.A total of 66 neonates who were diagnosed as HIE were placed into HIE group,while a total of 62 neonates without HIE were divided into control group.Risk factors associated with HIE were collected and analyzed by one way analysis and multiple Logistic regression analysis. Results 1) One way analysis showed that the prevalence of gestational anemia (χ²=13.84),gestational diabetes mellitus (χ²=21.27),hypertensive disorder complicating pregnancy (χ²=3.98),placental abruption (χ²=4.43),cord entanglement (χ²=3.70),intrauterine infection (χ²=9.16) and amniotic fluid contamination (χ²=8.27) in HIE group were significantly greater than those in control group(P<0.05 or <0.01).2) Logistic regression analysis showed gestational anemia (OR=8.24),gestational diabetes mellitus (OR=11.14),hypertensive disorder complicating pregnanc (OR=6.78),placental abruption (OR=6.94),cord entanglement (OR=6.51) and amniotic fluid contamination (OR=3.11) were independent HIE risk factors(P<0.05 or <0.01). Conclusions Gestational anemia,gestational diabetes mellitus,hypertensive disorder complicating pregnanc,placental abruption,cord entanglement and amniotic fluid contamination can increase the risk of HIE.Comprehensive preventive nursing strategies and therapy need to be taken in order to reduce the risk of HIE.   

Analysis of the distribution of Gram-negative bacilli strains and drug resistance in neonatal intensive care unit

BAI Bo,CHEN Bo,LI Guang-hong,WANG Yan-ping,HUANG Hui-yi,LUO Hui-ling

2017, 25(2):  187-190.  DOI: 10.11852/zgetbjzz2017-25-02-23

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Objective To investigate the distribution and drug resistance of common Gram-negative bacteria causing nosocomial infection in neonatal intensive care unit (NICU) and provide the evidence for use of antibiotic reasonably. Methods The samples of sputum,blood,urine and so on from 1 221 inpatients with suspicious infectious diseases in NICU of the authors' hospital were collected,cultured and isolated during the period from January 2014 to June 2016.Antimicrobial susceptibility testing was carried out using instrumental automated analysis system or Kirby-Bauer Method and their susceptibility data were analyzed according to CLSI standard. Results A total of 235 Gram-negative bacilli strains were isolated from 2 133 specimens and accounted for 56.5%(235/416)in all isolated pathogenic bacterial strains.The top five pathogens were Escherichia coli (29.8%),Klebsiella pneumoniae (28.9%),Pseudomonas aeruginosa (13.2%),Acinetobactor baumannii (6.1%),and Stenotrophomonas maltophilia (5.9%).The isolation rates of Escherichia coli and Klebsiella pneumoniae with positive extended-spectrum beta-lactamases (ESBLs) were 45.7% (32/70) and 39.7% (27/68),respectively.The drug resistance rates of those two bacteria to aztreonam,cefepime,ceftriaxone,cefotaxime,tobramycin and ampicillin were considerably higher (53.1%~100%) but significantly lower to antimicrobial supplemented with beta-lactamases-inhibitors.No strains of Escherichia coli or Klebsiella pneumoniae was found resistant to carbapenem.However,the resistance rates of Pseudomonas aeruginosa,Acinetobactor baumannii and Stenotrophomonas maltophilia to imipenem were 16.1%,21.4%,and 100%,respectively.Besides,all Gram-negative bacilli retained highly susceptibility to ciprofloxacin or levofloxacin. Conclusion The major pathogens in NICU of authors' hospital is Gram-negative bacilli.Regular monitoring and rational evaluation about distribution and drug resistance of bacteria may provide the evidence for empirical application of antimicrobial drugs and contribute to the reduction of antibiotic resistance.

Nutritional status of children aged 6~24 months in rural Wuling mountainous area

XIAO Ti-gan,ZENG Ju-hua,HUANG Zhi

2017, 25(2):  191-193.  DOI: 10.11852/zgetbjzz2017-25-02-24

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Objective To investigate the nutritional status of children aged 6~24 months in rural Wuling mountainous area,and further provide evidence for the improvement of nutritional status. Methods A total of 2 228 children aged 6~24 months from rural countries in Mountainous area of Wuling were selected with the PPS sampling.Their height and weight were measured and calculated based on WHO Child Growth Standards. Results The prevalence of child malnutrition in children aged 6~24 months in wuling area was 13.20%.Among the children with malnutrition,growth retardation had the most case(8.71%),followed by underweight(6.19%) and marasmus(3.90%).The prevalence of malnutrition had significant differences in sex,nationality as well as area. Conclusion Long-term and chronic nutritional deficiency is the main problem of malnutrition in Wuling mountainous area and effective measures of nutritional intervention should urgently be taken to improve nutritional status in this area.   

Analysis of accidental mortality in children under five years old in Chengdu,China from 2005 to 2014

YANG Liu,ZHANG Jian-xin,LI Chun-rong,ZHAO Shun-xia,CHEN Huai-liang

2017, 25(2):  194-197.  DOI: 10.11852/zgetbjzz2017-25-02-25

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Objective To explore the the epidemiological status,characteristics and the major causes of accidental mortality in children under five years old in Chengdu,China and provide scientific basis for policy setting to reduce the under-5 mortality. Methods A retrospective analysis was conducted through a province-based surveillance networkin in Chengdu from 2005 to 2014.The accidental mortality and the major causes in children under 5 years old were analyzed by trend chi-square test and rank test with SPSS 19.0 software. Results The decline trends of the total mortality in children under 5 years old were found in Chengdu from 2005 to 2014,especially in neonatal and the infant above 28 days.The mortality of children aged 1 to 4 years old and the accidental mortality of all ages did not show the significant decline trends.However,the proportion of accidental death in total mortality increased in children under 5 years old (χ²=4.50,P=0.03).Accidental suffocation was the leading cause of accidental deaths among the newborns and infants,making up 88.37% and 83.85% of the total accidental deaths,respectively.Drowning and traffic accident were the top two causes of accidental death in children aged 1 to 4 years old,making up 58.16% and 16.51%,respectively.The accidental mortality in urban areas did not decline (P＞0.05),while the accidental mortality in rural areas decline (P＜0.05).The causes of death were different between the urban and rural areas.The three leading causes of death in urban areas were accidental asphyxia (38.48%),drowning (22.49%) and traffic accidents (15.44%); Unlike the main causes in urban areas,the three leading cause were drowning (41.45%),accidental asphyxia (33.79%) and traffic accident (12.08%) in rural areas. Conclusions Accidental injury has become the major causes of death in children under 5 years old in Chengdu.Accidental injury should be strengthed to reduce the mortality in children under 5 years old.Enhancing the health education for parents and improving social emergency management system are the important strategies to reduce the accidental mortality in children under 5 years old in Chengdu.   

Effects of fluoride ion infiltration on prevention of deciduous teeth caries among preschool children

CHEN Ling,DENG Hong-yan,ZHANG Zhong-liang,QIN Rui,CHEN Jian

2017, 25(2):  200-202.  DOI: 10.11852/zgetbjzz2017-25-02-27

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Objective To explore the effects of fluoride ion infiltration on prevention of deciduous teeth caries of preschool children. Methods Preschool children aged 3~4-year-old from 28 preschools were selected and divided into two groups by the means of stratified cluster random sampling.The children in experimental group received oral health guidance and a bi-annual fluoride ion infiltration with NF-Ⅱ type application produced by Nanjing Medical University,and the children in control group only received oral health guidance.After two years,the prevalence of dental caries,the mean number of decayed,missed and filled teeth (dmft) and new caries morbidity were calculated. Results After two years,it was found that the prevalence of dental caries in the experimental group and the control group was 67.9%,74.3%,respectively.The mean number of decayed,missed and filled teeth (dmft) was 3.5±3.9,4.9±3.7,respectively.The new caries morbidity was 17.3%,23.4%,respectively.All of this index were significant different between the two groups (P＜0.05). Conclusion A biannual professional fluoride ion infiltration is effective in reducing the caries rate in deciduous teeth.   

Analysis of risk factors for children with cerebral palsy complicated by epilepsy

QIAO Wen-xing,YAN Chun-hong

2017, 25(2):  203-205.  DOI: 10.11852/zgetbjzz2017-25-02-28

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Objective To analysis the risk factors of cerebral palsy (CP) children with secondary epilepsy risk factors and provide reference for the prevention and treatment of CP children with epilepsy seizures. Methods Clinical data of 477 cases of children with CP in our hospital from May 2008 to January 2015 were retrospective analyzed.According to the children in hospital had seizures or not,children were divided into epilepsy group (case group) and the non-epilepsy group (control group),the general clinical data and imaging data of two groups were comparied,and the related factors were analyzed by Logistic regression analysis. Results In 477 patients with CP,86 cases merge epilepsy (18.0%),most (61.6%) children with epilepsy with tetraplegia,stiffness matrix cramps seizure was the main type of seizures (44.2%).Multiariable Logistic regression analysis suggested that low birth weight (OR=2.793,P<0.05),the softening of the brain (OR=3.185,P<0.05),intracranial hemorrhage (OR=3.581,P<0.05),the structure of the brain malformation (OR=5.839,P<0.05) were independent risk factors of CP children with epilepsy. Conclusions In children with CP,a softening of the brain,intracranial hemorrhage,low birth weight and brain structure abnormalities significantly increased the risk of epilepsy,which should be given clinical attention.   

The value of tandem mass spectrometry in high risk infants with primary carnitine deficiency

CHEN Da-yu,LI Zhe-tao,TAN Jian-qiang,ZHENG Min

2017, 25(2):  206-207.  DOI: 10.11852/zgetbjzz2017-25-02-29

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Objective To investigate the carnitine spectrum metabolism level of high-risk children of primary carnitine deficiency by using tandem mass spectrometry (MS/MS) in 2 493 patients.And to value tandem mass spectrometry application in diagnosis of primary carnitine deficiency. Methods 2 493 cases of high-risk children suspected genetic metabolic disease were selected from January 2013 to 2016 April in authors' hospital.Carnitine spectrum were detected by tandem mass spectrometry screening and confirmed by gene sequencing. Results 55 patients (2.21%) were positive for carnitine metabolism disorders;10 patients (0.4%) were diagnosed as primary carnitine deficiency.There were five types of pathogenic mutation sites. Conclusion The incidence of primary carnitine deficiency in high-risk children is higher and the type of genic mutation is different from that in other regions.Tandem mass spectrometry technology is helpful to the early diagnosis of this disease in high-risk children and provide a basis for clinical diagnosis and treatments.   

Application of health education path in infant early education

XIANG Hui,CHEN Hong,LI Xue-li

2017, 25(2):  208-210.  DOI: 10.11852/zgetbjzz2017-25-02-30

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Objective To investigate the effect of health education path in children's early education,in order to seek effective Methods for infant education. Methods In March 2014,65 infants aged 30~42 days receired physical examination in children health care clinic of the Second Affiliated Hospital of Xinjiang Medical University were selected according to selection criteria,who were divided into the intervention group (34 cases) and the control group (31 cases),early education related content training was implemented according to the health education path in the intervention group,while controversial health education was implemented in the control group.Two groups were not participated in any early education institutions.Two groups over 1 year of age were testing of the development quotient,weight and height and the incidence of common diseases and the evaluation of the effect. Results The adaptability,fine motor and personal social with intervention group were higher than those of the control group 6 points or so;The big movement and language were higher than those of the control group(about 11 points),the differences were statistically significant (P<0.05).There was no significant difference in weight and height between the two groups (P>0.05).The incidence rate of common disease with the intervention group was less than the control group (P<0.05). Conclusion The application of health education pathway in early childhood education can effectively improve the mental development of infants,reduce the incidence of common diseases,and is worth to be popularized.