Table of Content

10 July 2019, Volume 27 Issue 7

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Progress on the epigenetic knowledge of dietary nutrition and the development in early life

ZHANG Ting

2019, 27(7):  697-700.  DOI: 10.11852/zgetbjzz2019-0908

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The development in the first thousand days of a child is closely accompanied by epigenetic dynamic programming and regulation. This process is closely related to the early dietary balance of children,which reflects the interaction between body environment and genetics. This paper introduces the functional genome compared to the computer′s hardware system and software operating system,as well as the concept of ′genetics in our food′. Furthermore,the close correlation among body′s dietary nutrition intake,the three biochemical basic metabolism in cells and genomic chemical modification is emphasized in this paper,thereby providing more scientific genetic and epigenetic basis for daily professional guidance on children′s nutrition balance

Association between sleeping time and onset of menarche among Chinese girls aged 9 to 14 years

WEN Bo, DONG Yan-hui, YANG Zhao-geng, WANG Xi-jie, LI Yan-hui, DONG Bin, ZOU Zhi-yong, MA Jun

2019, 27(7):  701-705.  DOI: 10.11852/zgetbjzz2018-0858

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Objective To explore the association between sleeping time and onset of menarche among Chinese girls aged 9 to 14 years,in order to provide scientific reference for further study on the influencing factors of adolescent sexual development. Methods Girls aged 9 to 14 years were selected from database of Chinese National Survey on Students Constitution and Health in 2014 with complete record of height,weight,sleeping time,age at menarche. The subjects were divided into sufficient sleep group and sleepless group. Situation of menarche was asked by female physicians. The expected answer for this question was ′Yes′ or ′No′ without a specific date. Logistic model and multilevel Logistic model were used to investigate the association between age at menarche and sleeping time. Results Totally 48 096 female students were included in this study.The average report rate of sufficient sleep for girls aged 9 to 14 years was 31.34% (15 074/48 096). The average report rate of menarche for girls aged 9 to 14 years was 50.13% (24 112/48 096). The report rate of menarche increased with age,from 0.97% (22/2 258) at the age of 9 years old to 95.87% (1 832/1 911) at the age of 14 years old in sufficient sleep group and 1.52% (52/3 423) at the age of 9 years old to 97.32% (6 720/6 905) at the age of 14 years old in sleepless group. The occurrence rate of menarche in sufficient sleep group was lower than that in the sleepless group in each age group (P<0.05). After controlling for district,height,BMI and other factors,girls aged 10 to 14 years were less likely to have the onset of menarche in sufficient sleep group compared with the sleepless group (OR=0.73,95% CI:0.69-0.77). Multilevel Logistic model indicated that after controlling for other factors,the longer the sleep duration was,the later of the menarche onset would be(OR=0.90,95%CI:0.87-0.92). Besides,the relationship between sleep duration and menarche onset did not have group cohesion at the province level(ICC <0.01),while the group cohesion at the age level was significantly strong(ICC=0.61). Conclusions The sleep duration of adolescents is closely related to the age at menarche and could have influence on the onset of menarche,which may be a key factor of the puberty development and sexual maturation. Effective measures should be taken to ensure the normal sleep duration of children and adolescents,so as to ensure their healthy growth

Clinical significance of complement C5a and related inflammatory factors in obese children hypertension

YIN Chun-yan, WANG Li, XIAO Yan-feng

2019, 27(7):  706-709.  DOI: 10.11852/zgetbjzz2018-1169

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Objective To analyze the effect of complement C5a and related inflammatory factors on blood pressure and its role in hypertension in obese children,in order to provide scientific reference for clinical intervention. Methods A cross-sectional study was conducted from July 2016 to August 2017 among 71 obese children,recruited from the Second Affiliated Hospital of Xi′an Jiaotong University.Children′s height,weight,waist circumference,body mass index (BMI) and blood pressure were measured.According to the blood pressure measurement results,systolic blood pressure (SBP) and/or diastolic blood pressure(DBP)≥same age P₉₅ as hypertension were further divided into hypertension group and non-hypertension group.Serum insulin,IL-6,C5a,hsCRP and TNF-α were detected by enzyme linked immunosorbent assay(ELISA).The insulin resistance index (HOMA-IR) was calculated and the test results were analyzed. Results The levels of HOMA-IR,triglyceride (TG),total cholesterol (TC),TNF-α,IL-6 and complement C5a in hypertensive children were significantly higher than those in non-hypertensive children (P<0.05).Pearson correlation analysis showed that both SDS-DBP and SDS-SBP were related to the levels of TNF-α,hsCRP,IL-6 and C5a(P<0.05).Multiple linear regression showed that SDS-BMI,waist circumference,IL-6,C5a and hsCRP were significantly correlated with SDS-SBP (P<0.05).Moreover,IL-6,C5a and hsCRP were significantly correlated with SDS-DBP. Conclusion IL-6,hsCRP and C5a play an important role in the development of hypertension in obese children,and may be the risk factors for hypertension

Study on the effects of healthy life style intervention on the blood uric acid of preschool children

LI Nan, ZHANG Shuang, LENG Jun-hong, LI Wei-qin, WANG Lei-shen, LIU Hui-kun, LI Wei, DU Yue-xin

2019, 27(7):  710-713.  DOI: 10.11852/zgetbjzz2018-1012

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Objective To investigate the effectiveness of life style intervention on preschool children with hyperuricemia(HUA). Methods A cross-sectional survey was carried out in six central urban districts of Tianjin from March to June 2015. And 242 children aged from 3 to 6 years with the elevated blood uric acid levels were randomly divided into the intensive intervention group(n=122) and routine health care group(n=120). Children with the elevated blood uric acid levels in the intensive intervention group were intensively intervened on the diet,exercise guide,health education. Children in both groups were reexamined after at least 3 months,and finally 204 children had reexamination. Results The levels of blood uric acid in the intensive intervention group and in routine health care group were (357.7±44.3)μmol/L and (363.3±44.5)μmol/L at baseline time. The levels of blood uric acid in the intensive intervention group and in routine health care group were (287.6±42.1)μmol/L and (336.2±65.2)μmol/L at reexamination time. The reduction of levels of blood uric acid in the intensive intervention group was more than that in routine health care group and the difference was of statistical significance(t=-4.841,P<0.001). At the time of reexamination,the rates of recovery to the normal level in the intensive intervention group and routine health care group were 72.7% and 44.7%,respectively(χ²=16.586,P<0.001). Conclusion The individualized intervention of life styles and health education may reduce the prevalence of hyperuricemia in preschool children

Study on the association between depressive symptoms and obesity among children in Dongcheng district,Beijing

LIU Zheng, GAO Ai-yu, LIN Li-zi, LI Chen-xiong, WANG Hai-jun

2019, 27(7):  714-716.  DOI: 10.11852/zgetbjzz2018-1231

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Objective To study the association between depressive symptoms and obesity among primary school students,in order to provide evidence for interventions on childhood obesity and mental health. Methods A cross-sectional survey was conducted in 12 primary schools of Dongcheng district in Beijing. A total of 1 412 students in Grade 3 to 5 were selected to self-report depressive symptoms through Childhood Depression′s Inventory (CDI). Students′ nutritional status was classified based on Chinese standards. The t tests,Pearson chi-square tests and linear mixed model were used to analyze the relationship between depression scores,body mass index (BMI) and BMI-Z,depressive symptoms and obesity,and to know about whether gender and depressive symptoms had additive effects on obesity. Results The average score of depressive symptoms was 9.75±6.38 in 1 412 participants aged 7 to 11 years. The prevalence rates of students with depressive symptoms were 13.1% and 6.7% for boys and girls,respectively. And 28.6% of students with depressive symptoms were obese,while it was 18.7% in students without depressive symptoms,and the difference was significant (P<0.05). After adjusting school,age and gender,BMI and BMI-Z increased by 0.04 (95%CI:0.01-0.07) and 0.01(95%CI:0.001-0.020)when depression scores increased by 1. Compared with students without depressive symptoms,the risk of developing obesity among students with depressive symptoms rose significantly (OR=1.54,95%CI:1.03-2.29). The combined effect of gender and depressive symptoms on obesity was found to be significant. Conclusions Depressive symptoms are associated with obesity in children. More attention should be paid to mental health in obese children,and it is suggested to give high-risk children psychological intervention

Clinical study on the changes of bone metabolic index after treatment of gonadotrophin releasing hormone analogue in girls with central precocious puberty

TAO Na, ZHANG Hong-hong, LING Yu, SUN Mei-yuan, WANG Ai-ping, YANG Yang

2019, 27(7):  717-719.  DOI: 10.11852/zgetbjzz2018-0967

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Objective To explore the dynamic changes and clinical value of bone metabolic index after gonadotrophin releasing hormone analogue (GnRHa) treatment in girls with central precocious puberty(CPP),in order to provide scientific reference for clinical treatment. Methods Totally 36 CPP girls treated with GnRHa and 36 healthy girls as controls were enrolled in this study from October 2015 to June 2016,and were tested for serum bone mineralogy,bone formation and common serum levels before treatment and 6 months,12 months,18 months and 24 months after treatment. Bone resorption marker levels were compared in groups and different time points. Results At the end of the study,the observation group lost 5 (13.89%) cases,and the control group lost 4(11.11%) cases. There were no significant differences on blood Ca,P,25-(OH)D₃ and β-CTX between CPP group and control group at each time point after treatment (P＞0.05). Blood E2,N-MID OC,P1NP and BALP decreased gradually after treatment,and there was statistically significant difference between CPP group and control group at each time point (P<0.05). Conclusions Estrogen level in children is significantly reduced during the first 12 months of treatment with GnRHa. And the effect of GnRHa on osteoblasts is more pronounced than that on osteoclasts.

Analysis on the status quo of supplementary food and nutrient addition ininfants and toddlers aged 6 to 24 months in a poverty county in Shaanxi Province

ZHANG Min-li, WANG Hang-hui, BAI Bo, CHENG Sheng-quan, LIANG Juan

2019, 27(7):  720-723.  DOI: 10.11852/zgetbjzz2018-0869

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Objective To analyze supplementary food and nutrient addition in infants and toddlers aged 6 to 24 months in a poverty county in Shaanxi,so as to provide reference for promoting the nutritional health of infants and toddlers in the region. Methods A cluster stratified random sampling method was used to survey the status quo of supplementary food and nutrient additions in 920 infants and toddlers aged 6 to 24 months in a poverty county in Shaanxi from July to August in 2017,and the data were analyzed. Results Supplementary foods for infants and toddlers were small in variety,mainly in cereals(82.0%) and eggs(54.0%).Inadequate intake of calcium calcium,vitamins A(8.8%) and vitamins D(10.0%) was unreasonable.Supplementary foods were added too early or too late.The average intake ratio of three major nutrients per person per day for infants and toddlers did not meet the standards set by the Chinese Nutrition Society for dietary reference intake (DRIs).With the increasing of age,the percentage of carbohydrate RNI gradually increased,and the ratio of protein to fat intake decreased.The intake of calcium iron,zinc and sodium in infants aged 12 to 18 months after weaning was 274.5 mg,3.3 mg,2.4 mg and 198.6 mg,respectively,while it was 298.3 mg,3.8 mg,2.4 mg and 175.5 mg in toddlers over 18 months.The actual intake of vitamin A,D,B1,B2,C and E in infants and toddlers was lower than the DRIS standard. Conclusions The supplemental foods and nutrients in infants and toddlers aged 6 to 24 months in a poverty county in Shaanxi Province are not balanced,and early or late additions exist.The three major nutrient intake ratios do not meet the DRIS standards set by the China Nutrition Society.The actual intake of minerals and vitamins is lower than the DRIS standard.Therefore,it is necessary to spread the knowledge on infant food supplement and nutrient addition in poor areas

Analysis on the correlation of birth weight with physical development and glycolipid metabolism during infancy

WU Qiao-ling, YU Wen, GONG Chun-dan, ZHANG Dan, ZHAO Zheng-yan, PENG Yong-mei

2019, 27(7):  724-728.  DOI: 10.11852/zgetbjzz2018-0849

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Objective To investigate the correlation of birth weight (BW) with children′s physical development and glycolipid metabolism during infancy,and to analyze the influencing factors of infant catch-up growth. Methods A total of 1 064 mother-child pairs were randomly recruited and the perinatal baseline information,anthropometric indexes and feeding data of children aged 0 to 18 months were recorded. The neonatal cord blood and the venous blood of 18-month-old children were tested for glycolipid metabolism indexes. Results BW of newborns presented significantly positive correlation with serum high sensitivity C-reactive protein (hCRP) but negative correlation with triglyceride (TG) ,and positive correlation between BW with lipoprotein a (Lpa) was found only in female infants (P<0.05). At 18 months old,negative correlation was found between BW with fasting glucose (GLU) in male and high density lipoprotein cholesterol (HDL-c) in female (P<0.05). Within 6 months old,significantly negative correlation between BW and children′s physical development was detected,and low birth weight (LBW) infants showed significantly more physical catch-up growth (P<0.01). Lower BW,mashed and fluid supplementary food were found to be promoting factors of body mass index Z score(BMIZ)catch-up growth within 6 months old,while paternal hypertension,eating slowly,higher fish-species consumption frequency and higher family income were shown to be weakening factors for BMIZ catch-up growth. Conclusions Extremely high or low of BW is likely to have adverse effects on glycolipid metabolism. Significant higher BMIZ catch-up growth in LBW infants within 6 months old may increase the risk of metabolic syndrome (MS) in adulthood

Effect of Caltrate D combined with recombinant human growth hormone on bone metabolization indexes and serum levels of IGF-1,25-(OH)D in children with idiopathic short stature

TANG Xiu-ping, LI Ling, YAN Bao-rui

2019, 27(7):  729-732.  DOI: 10.11852/zgetbjzz2018-1525

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Objective To analyze the efficacy of Calcium D combined with recombinant human growth hormone (rhGH) in the treatment of children with idiopathic short stature (ISS) and its effect on serum levels of bone metabolization indexes,insulin-like growth factor-1 (IGF-1),25-hydroxyvitamin D[25-(OH)D].Methods Totally 90 children with ISS (ISS group) in Zhengzhou Yihe Hospital Affiliated to Henan University from January 2015 to June 2017 were enrolled in this study,and were randomly divided into observation group and control group,with 45 cases in each group. The control group was treated with rhGH,the observation group was treated with rhGH and Calcium D. And 45 children taking physical examination matched by sex and age were selected as normal group. The height (Ht),bone age (BA),growth rate (GV),height standard deviation score (HtSDS),BA-to-chronological age (BA/CA) and serum levels of bone metabolization indexes[osteocalcin (OC),type I procollagen amino terminal prolongation peptide (P1NP)],IGF-1 and 25-(OH)D of observation group and control group were observed before treatment,6 and 12 months after treatment. The indexes were compared with normal group. Results The BA,Ht,GV,HtSDS,BA/CA and serum levels of OC,PICP,IGF-1,25-(OH)D in the ISS group were significantly lower than those in normal group (P<0.05). After 6 and 12 months of treatment,the BA,Ht,GV,HtSDS,BA/CA and serum levels of OC,PICP,IGF-1,25-(OH)D in the observation group significantly increased (P<0.05). However,the 25-(OH)D in control group did not change significantly (P>0.05). Moreover,the Ht,GV,HtSDS,HtSDS and serum levels of OC,PICP,IGF-1,25-(OH)D in the observation group were significantly higher than those in control group (P<0.05). Conclusions There is abnormal bone metabolism and low level of IGF-1 and 25-(OH)D in children with ISS. Calcium D adjuvant therapy can improve bone metabolization and increase serum levels of IGF-1 and 25-(OH)D,thereby improving growth development

Research advance on infants complementary feeding

AN Na, HAN Tong-yan

2019, 27(7):  733-736.  DOI: 10.11852/zgetbjzz2018-1422

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There exist differences on the evidence of complementary feeding recommendations and practices at home and abroad. Not only parents but also doctors are confused about the appropriate time,content and ways of complementary feeding. Complementary food is necessary for both nutritional and developmental reasons,and is an important stage in the transition from milk feeding to family foods. Complementary feeding period is one of rapid growth and development stages when infants are susceptible to nutrient deficiencies and excesses,and during which there are marked changes in the diet because of exposure to new foods,tastes,and feeding experiences. This review summarizes the time,content and ways of complementary feeding recently,so as to update the knowledge of complementary feeding in infants

Research progress on the correlation between infant complementary foods and food allergy

CHENG Juan, SHEN Kun-ling, DUAN Hong-mei

2019, 27(7):  737-740.  DOI: 10.11852/zgetbjzz2018-1187

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At present,the relationship between infant complementary foods and prevention of food allergy has attracted more and more researchers′ attention. Studies have shown that because of the immune tolerance,the more types of complementary foods are added in the early stages,the lower the risk of food allergy is. In addition,the processing of complementary food is also associated with food allergies. On account of the high homology or similar antigenic determinants of different allergens,there is cross-reaction in some food.So in clinical practice,health care providers are supposed to make comprehensive evaluation of the individual situation of infants,genetic family history and even the results of food allergy experiments,then draw up an individualized supplementary food scheme with reference to the clinical guidelines and the latest evidence from the research results,which will help infants prevent food allergies and related allergy disease

Research progress on catch-up growth of low birth weight premature infants

LIU Fang, WANG Jun-ling, YAO Bao-zhen

2019, 27(7):  741-744.  DOI: 10.11852/zgetbjzz2018-0905

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Low birth weight premature infants are special populations in neonates,and catch-up growth is a typically developmental phenomenon in premature,low birth weight infants,growth-restricted or retarded children. It is of great significance to promote the growth and brain development of low birth weight preterm infants and to improve their prognosis by achieving the ideal catch-up growth. This review summarizes research advances at home and abroad,including catch-up growth characteristics of low birth weight premature infants,neuropsychological developmental outcomes and the impact of unsuitable catch-up growth on later health in these children

Recent advances in catch-up growth and metabolic syndrome of premature infants

WANG Si-xian, LIANG Kun

2019, 27(7):  745-748.  DOI: 10.11852/zgetbjzz2018-1690

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Metabolic syndrome (MS),also known as insulin resistance syndrome,mainly includes type 2 diabetes,obesity,abnormal blood glucose regulation,hypertension and dyslipidemia.Catch-up growth of preterm infants may compensate to the deficiency of extrauterine growth retardation,improve innate immune function,and promote mental and physical development.But it has been shown that catch-up growth is closely related to MS.This review summarizes the mechanism,early prediction and intervention of MS in adulthood caused by catch-up growth in preterm infants

Visual analysis of studies on the effect of electronic waste on the health of pregnant women and children

HAN Xue, PAN Jia-xue, HAN Xue-mei, SHAN Hou-qian, ZUO Li-qian

2019, 27(7):  749-754.  DOI: 10.11852/zgetbjzz2018-0900

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Objective To understand the current status and progress on researches regarding the impact of electronic waste (e-waste) on the health of pregnant women and children in foreign language literature,so as to provide theoretical basis and innovative ideas for further research in this field in China. Methods Based on bibliometrics Methods combined with information visualization,bibliographic information co-occurrence mining system(BICOMS) analysis software was used to extract and collate the information of topic words,and co-occurrence matrix was generated.NetDraw was used to arrange the relationships among the main headings and draw social network diagrams.Also,gCLUTO cluster analysis was used for clustering analysis.According to the actual clustering effect,the final choice of the main topic words gathered into three categories,visual surface maps and visualization matrix were generated. Results There were 5 018 studies regarding the impact of e-waste on the health of pregnant women and children.The number of studies was balanced in the distribution of age,journals,authors and countries.In 5 018 studies,there are 3 975 main subject words with substantial meaning,And the lower the frequency of main subject words was,the more the number of main keywords would be.Among them,there were 303 main subject words appearing more than 10 times,1 962 main subject words appeared once,and 32 main themes appeared more than 59 times,which was the main research direction of the impact of e-waste on pregnant women and children.The results of social network analysis showed that there were 14 high-frequency main keywords in the middle of the social network,with the largest centrality. Conclusions The impact of environmental pollution on disease,behavior and development in children and adolescents,the impact of maternal and occupational exposure to e-waste on disease are three key areas in the researches about the impact of e-waste on the health of pregnant women and children.In recent years,foreign researchers have gained great achievements on the above three aspects,however,there are still few studies on ways of affecting health of pregnant women,mechanism,preventive measures and prognosis research.In addition,the impact of e-waste on the health of pregnant women and children is very less-researched in China,so further research is warranted

Analysis of the blood pressure of children and adolescents in Urumqi city

MIAO Rui-jing, LIU Shi-ru, LI Su-jun

2019, 27(7):  755-757.  DOI: 10.11852/zgetbjzz2018-1315

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Objective To understand the correlation between blood pressure (BP) and body mass index (BMI) of children and adolescents in Urumqi,so as to provide support for the prevention of hypertension in children and adolescents in this area. Methods A total of 41 028 children and adolescents from 15 high school,junior high school and primary school were selected based on the principle of convenient sampling in Urumqi City from September to October in 2016.The height,weight and blood pressure were tested and analyzed. Results The detection rate of hypertension among children and adolescents in Urumqi City was 12.75%,and boys had significantly higher hypertension rate than girls(13.77% vs.10.92%,χ²=75.31,P<0.01).Moreover,the detection rates of high systolic blood pressure,high diastolic blood pressure and hypertension in children and adolescents with obesity and overweight were higher than those in normal students,and the differences were significant (χ²=758.8,114.2,623.0,P<0.01). Conclusions The blood pressure of children and adolescents in Urumqi is not optimistic.Overweight and obesity are the main causes of hypertension in children and adolescents.In the future,the blood pressure of overweight and obese children should be given more concerns

Epidemiology of overweight,obesity and hypertension among preschool children in Jing′an district of Shanghai

HUO Yan-yan, WU Dan, WANG Xiu-lian, SUN Fan-fan, GUO Qian-wen, LIU Mei-yan, CHEN Jin-jin

2019, 27(7):  758-760.  DOI: 10.11852/zgetbjzz2018-1073

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Objective To investigate the prevalence of overweight,obesity and hypertension among preschool children in Jing′an district of Shanghai,in order to provide evidence for relevant intervention measures. Methods A total of 3 608 preschool children aged 3~7 who took physical examination in kindergartens in Shanghai Jing ′an district in 2017 were selected as participants in this study.Data were analyzed by SPSS 24.0 with the reference of World Health Organization (WHO) child growth standards and blood pressure reference standard of children and adolescent in China. Results The overweight and obesity detection rate of 3 to 7-year-old preschool children in Shanghai Jing ′an district was 9.3% and 9.2%,respectively.The obesity rate of boys was higher than that of girls,and the rates of overweight and obesity of 6 to 7-year-old children was significantly higher than those in other age groups (P<0.05).However,there were no significant differences on the detection rate of overweight between boys and girls(P＞0.05).The overall rate of hypertension was 1.5%,which was significantly higher in boys and obese children than that in girls and children with overweight and normal weight (P< 0.001).But the differences on hypertension detection rates among different age groups were not significant (P＞0.05). Conclusion The rate of overweight,obesity among preschool children in Jing′an district of Shanghai is quite high,prevention of related chronic diseases should be carried out early in preschool children

Effect of vitamin D deficiency on serum ferritin in children

ZHANG Zhen-hong, NI Ming, HU Yuan, LIU Dong-qiang

2019, 27(7):  761-763.  DOI: 10.11852/zgetbjzz2018-1516

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Objective To understand the status quo of vitamin D deficiency in children,and to analyze the effects of vitamin D deficiency on serum ferritin. Methods Children aged 6 months to 14 years,who took physical examination in Dongguan Children′s Hospital from November 2016 to April 2018 were enrolled in this study.Serum ferritin and vitamin D concentrations of children were measured.Statistical analysis was performed by SPSS 24.0. Results The overall prevalence rate of vitamin D deficiency was 34.73%,and the prevalence rate of vitamin D deficiency in infants,preschoolers and school-age children was 19.75%,65.45% and 77.78%,respectively.The rate of iron depletion was 22.42%.The serum ferritin level in vitamin D normal group was higher than that in vitamin D depletion group and vitamin D deficiency group (F=6.21,P=0.002).Older age was a protective factor for iron depletion (OR=0.312,95%CI:0.233-0.419,P<0.001),and vitamin D deficiency was a risk factor for iron depletion (OR=1.377,95%CI:1.109-1.710,P=0.004). Conclusions The prevalence of vitamin D deficiency is still high in healthy children,and it increases with age.Vitamin D deficiency is one of the risk factors for decreased serum ferritin.Therefore,it is necessary to extend the duration of vitamin D supplements to reduce the prevalence of vitamin D deficiency in children.Besides,vitamin D concentration is suggested to be tested to rule out vitamin D deficiency for children with iron deficiency or poor efficacy of iron supplements

Analysis on characteristics and influencing factors for waist circumference among preschool children in urban area of Yangzhou

CHEN Qiu, CHEN Rui-mei, ZUO Xiao-yu, ZHANG Jing-li , WANG Lei , TAO Fang-biao

2019, 27(7):  764-767.  DOI: 10.11852/zgetbjzz2018-1214

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Objective To investigate the characteristics and influencing factors of waist circumference among preschool children in urban area of Yangzhou,so as to provide reference for the screening and prevention of abdominal overweight and obesity. Methods Totally 2 531 children were selected from 7 kindergartens from April to May in 2015 by stratified cluster sampling.And their parents were asked to finish a questionnaire investigation.The weight,height,waist circumference of children were measured by centralized physical examination,and were descriptively analyzed.The influencing factors of waist circumference were analyzed by univariate and multivariate Logistic regression analysis. Results Waist circumference increased gradually with age among preschool children in urban area of Yangzhou,and it was larger in boys than that in girls in each age group.Waist to height ratio in girls decreased gradually with age,while waist to height ratio in boys showed fluctuations.Univariate analysis showed that parental body mass index (BMI),maternal education,daily sleep time,outdoor activity time and screen time had influence on waist circumference of children (P<0.05).Multivariate Logistic regression analysis showed that high BMI of parents is a risk factor for high abdominal circumference in preschool children (mother BMI:OR=1.15,95%CI:1.09-1.18;father BMI:OR=1.12,95%CI:1.07-1.15). Conclusions It is supposed to establish the boundary value of normal waist circumference and waistline for abdominal overweight and obesity for preschool children in China,thereby promoting better screening and prevention of abdominal overweight/obesity.Besides,comprehensive intervention of family-centered diet and lifestyle is warranted in order to control abdominal obesity

Analysis of prevalence and related factors of physical development deviations and common diseases among 6 595 preschool children in Xi′an

REN Gui-ying, ZHANG Rui-juan, YANG Wei-dong, YANG Jing, YANG Ai-fang

2019, 27(7):  768-770.  DOI: 10.11852/zgetbjzz2018-1300

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Objective To understand the physical development deviation and common diseases status of preschool children in an urban area of Xi′an city,so as to provide reference for children health care work. Methods A stratified random cluster sampling method was used to select 6 862 children from 17 kindergartens in a district of Xi′an in 2017.The researchers were admitted to the kindergarten for physical examination from March to September,and 6 595 eligible results of children were finally analyzed. Results The rates of growth retardation,low body weight and wasting rate were 0.23%,0.14% and 0.94%,respectively.And the rates of overweight,obesity,dental caries and anemia were 12.87%,11.89%,15.51% and 5.14%,respectively.Boys had lower rates of body weight and obesity than girls (P<0.01).With the increase of age,the detection rate of growth retardation,low body weight,obesity,dental caries and anemia increased (P<0.001).Meantime,the rates of growth retardation,obesity and anemia of children in private kindergartens were higher than those in public kindergartens (P<0.01). Conclusion The proportion of dystrophy in preschool children in this district is relatively lower,and the rates of reaching standard of height and weight need to be further improved.Moreover,the absolute number of dental caries and anemia should not be ignored

Non-randomized clinical trial of repetitive transcranial magnetic stimulation in the treatment of children with Rett syndrome

WANG Chao, LI Hui-ping, ZHOU Bing-rui, LI Chun-yang, ZHANG Ying, DONG Ping

2019, 27(7):  771-774.  DOI: 10.11852/zgetbjzz2018-1810

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Objectives To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS) in the treatment of Rett syndrome(RTT),so as to provide reference for clinical treatment. Methods Totally 17 children with Rett syndrome who met the criterion were enrolled in this study from January 2015 to April 2018,and were non-randomly divided into the TMS group(n=7) and control group(n=10). The TMS group was given rTMS for 6 months,while the control group received routine follow-up. All children were tested for MECP2 gene and were assessed by Griffiths Mental Development Scale-Chinese Version(GDS-C),Peabody Development Motor Scales(PDMS),Children′s Sleep Habits Questionnaire(CSHQ),flash visual evoked potential(FVEP) and brainstem auditory evoked potential(BAEP) at admission and 6 months respectively. Results 1) The overall development and motor ability of the children in TMS group and control group showed obviously degenerative changes,but the differences between the two groups were not significant(P＞0.05). 2) The sleep duration of children in TMS group and control group was shorter. After 6 months of rTMS intervention in TMS group,the average sleep duration of children in TMS group was longer than that of control group,but there was no significant difference between the two groups[ΔTMS group:(0.83±0.97) h vs. Δ control group:(-0.40±1.20) h,P＞0.05]. 3) There were no significant changes on the results of FVEP and BAEP before and after treatment,so was the difference between the two groups(P＞0.05). 4) rTMS was safe during treatment and no adverse events were reported. Conclusions Repeated transcranial magnetic stimulation may prolong the sleep duration and improve the quality of sleep in RTT children. Moreover,rTMS treatment has no significant effect on the progression of mental and motor developmental levels in RTT children,as well as the parameters of FVEP and BAEP. Meanwhile,there are no serious adverse reactions during the use of rTMS

Study on the growth and development of the offspring from 0 to 36 months old of mothers with gestational diabetes mellitus

HOU Shan-shan, YANG Jie

2019, 27(7):  775-778.  DOI: 10.11852/zgetbjzz2018-1100

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Objective To explore the similarities and differences of growth and development from 0 to 36 months between the offspring of gestational diabetes mellitus (GDM) and normal mothers,in order to provide scientific reference for clinical intervention. Methods Children born between January 1st,2014 and December 31st,2014 in Tongzhou Maternal and Child Health Hospital,Beijing were selected. Children born to GDM mothers were selected as GDM group,and those born to normal women were selected as control group. Physical measurements were performed at the age of 3,6,12,18,24,30 and 36 months old,and the growth and development trends and speeds of the GDM group and control group were compared. Results The weight gained from 0 to 3 months old of children in GDM group was (2.81±0.83)kg,which was slower than (3.01±0.79)kg in the control group. And the body length of GDM group increased by (5.14±1.60) cm from 9 to 12 months old,which was faster than (4.70±1.69) cm in the control group. However,the body length of GDM group increased by (5.80±1.82) cm from 12 to 18 months old,which was significantly slower than (6.23±1.64) cm in the control group. The body mass index (BMI) of boys in GDM group at the age of 12 months old was (17.06±0.86)kg/m²,which was significantly lower than that in control group[(17.50±1.16)kg/m²]. Also,the BMI of girls in GDM group was significantly higher than that in control group[(17.73±1.61)kg/m² vs. (17.27±1.17)kg/m²]. Conclusions Children born to GDM mothers have growth retardation at the age of 0 to 3 months old,and then rapidly catch up with normal children. Moreover,there are differences on weight changes in different gender groups

Nutritional risk screening and its clinical value in children with severe pneumonia

WU Ling-ling

2019, 27(7):  779-781.  DOI: 10.11852/zgetbjzz2018-1047

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Objective To explore the nutritional risk of hospitalized children with severe pneumonia and its correlation with clinical outcome,so as to provide scientific basis for clinical nutritional treatment. Methods Totally 236 children with severe pneumonia aged 1 to 14 years in Pediatrics Department of People′s Hospital in Zaoqiang County were screened for nutritional risk using the child nutrition risk and dysplasia screening tool.Total protein,albumin,prealbumin and hemoglobin levels were tested by fasting blood sampling,and data such as mechanical ventilation time,infection complications,hospitalization time,total hospitalization cost and application of nutritional support were recorded for analysis. Results Children with low,moderate and severe nutrition risk accounted for 28.4%(67/236),48.7%(115/236) and 22.9%(54/236),respectively.The rate of severe nutrition risk in children aged 1 to 2 years and 3 to 5 years was obviously higher than the other two age groups(P<0.05).Also,the low nutrition risk in children 11 to 14 year-old children was significantly higher than that in the other three age groups(P<0.05).Moreover,14.0% received total parenteral nutrition support,25.5% had parenteral combined with enteral nutrition support,24.5% underwent total enteral nutrition support,and 36.0% were not given any nutritional support.The levels of total protein,albumin,prealbumin and hemoglobin in high nutrition risk group were lower than those in low nutrition risk group and moderate nutrition risk group.Likewise,high nutrition risk group had higher incidence of infectious complications,more days of hospitalization and higher hospital expenses than moderate or low nutrition risk group(P<0.05). Conclusion The nutrition risk is closely related to clinical outcome of children with severe pneumonia,so it is supposed to give rational nutrition intervention to the high-risk children.

Correlation between serum vitamin D level and extra-pulmonary involvement in children with mycoplasma pneumoniae pneumonia

SU Le, MEI Ling-hua, HE Qiao-feng

2019, 27(7):  782-785.  DOI: 10.11852/zgetbjzz2018-1262

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Objective To explore the correlation between serum vitamin D level and extra-pulmonary involvement in children with mycoplasma pneumoniae pneumonia (MPP),in order to provide theoretical evidence for clinical assessment. Methods Totally 158 MPP children admitted to Yulin First Hospital from December 2015 to December 2017 were enrolled in this study,and were divided into extra-pulmonary involvement group (n=56) and non extra-pulmonary involvement group(n=102).And all children were classified into normal vitamin D group,insufficiency group and deficiency group based on vitamin D level.Prevalence rates of extra-pulmonary involvement in different groups of vitamin D levels were compared. Results Compared with non extra-pulmonary involvement group,duration of fever in extra-pulmonary involvement group was much longer.And the levels of WBC,ESR,CRP,D-D were higher,while serum vitamin E and 25-hydroxyvitamin D[25-(OH)D] levels were significantly lower in extra-pulmonary involvement group(P<0.05).There were statistically significant differences on the prevalence rate of extra-pulmonary involvement children in different vitamin D level groups (P<0.05).Multivariate Logistic regression analysis showed that vitamin D insufficiency (OR=1.955,95%CI:1.479-4.233,P=0.006) or deficiency(OR=2.360,95%CI:1.687-8.215,P＜0.001) were independent risks factor of extra-pulmonary involvement (P<0.05).ROC curve analysis showed that the area under curve (AUC) of serum 25-(OH)D level predicting extra-pulmonary involvement was 0.840,and its sensitivity and specificity were 81.45% and 87.76% respectively.The optimal cut-off point of serum 25-(OH)D level was 22.48 ng/ml. Conclusions vitamin D insufficiency or deficiency significantly increase the risk of extra-pulmonary involvement in MPP children,and may be the predictive factor for its occurrence independently.So vitamin D level should be closely monitored to evaluate prognosis of MPP children in clinical practice

Study on lymphocytes proliferation and cytokine production in children with iron deficiency anemia

HU Hong-bo, GUO Hong, SHI Zu-liang, QIN Liu, LI Xue-mei

2019, 27(7):  786-788.  DOI: 10.11852/zgetbjzz2018-0962

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Objective To evaluate the effect of iron deficiency on lymphocyte proliferation and cytokine secretion in children with iron deficiency anemia (IDA),and to explore the causes of the decline of immune function in children caused by IDA. Methods Totally 20 IDA children were selected in IDA group and 20 healthy children were selected as control group from March 4th to April 28th in 2018. The lymphocyte stimulating index under 10μmol/L,20 μmol/L and 50 μmol/L iron supplementation from IDA group and control group was examined by MTT. The production of INF-γ,IL-2,IL-6 and IL-10 by peripheral blood mononuclear cells (PBMC) under different iron supplementation was examined by ELISA. Results 1) In the control group,SI of B and T cells under iron concentration of 20 μmol/L was significantly higher than that in other iron concentration levels,and was also significantly higher than that under iron concentration of 20 μmol/L in IDA group. Moreover,the SI of IDA children was significantly increased after physiological concentration iron supplementation.2) PBMC from IDA patients showed significantly lower production of INF-γ and IL-2 at all iron concentration levels than PBMC from healthy controls,but INF-γ and IL-2 levels at the concentration of 20 μmol/L were significantly higher than those at the concentration of 10 μmol/L group.3) The secretory levels of IL-6 and IL-10 in IDA group were significantly higher than those in control group at the concentration of 10 μmol/L and 20 μmol/L. Conclusion The changes of T,B lymphocyte proliferation and cytokine secretion in IDA children may be one of the reasons for the imbalance of immune function and weakening immune system

Study on the current status and influencing factors for nutrition of middle school students in Yongning County, Ningxia Hui Autonomous Region

ZHAO Hong-yan, ZHANG Ying, LIU Hui, YUAN Wen-zhen, FANG Xiang, HUANG Xiao-dan, LONG Dan-feng, WANG Yu

2019, 27(7):  789-792.  DOI: 10.11852/zgetbjzz2018-0870

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Objective To know about the nutritional status and its influencing factors in middle school students from Yongning County,Ningxia Hui Autonomous Region,in order to provide theoretical basis for scientific intervention on improving nutrition status. Methods A total of 1 091 middle school students were selected to take physical examination and fill out questionnaires. Body mass index (BMI) was used to evaluate nutritional status and Logistic regression analysis was used to analyze influencing factors of nutritional status. Results The detection rates of malnutrition,normal nutrition,overweight and obesity among the 1 091 middle school students were 13.75%,77.18% and 9.07%,respectively. The detection rates of malnutrition and overweight and obesity in boys (16.67%,14.23%) were significantly higher than girls (11.35%,4.84%). The prevalence of overweight and obesity in only children (13.70%) was significantly higher than that in children with siblings (7.55%). The protective factors for malnutrition of middle school students included female (OR=0.611,95%CI:0.422-0.883),maternal occupation of individual business(OR=0.242,95%CI:0.093-0.626) and non-picky eaters(OR=0.602,95%CI:0.420-0.862). No family history of obesity (OR=2.513,95%CI:1.059-5.959) was a risk factor for malnutrition in the area. Meanwhile,the protective factors for overweight and obesity of middle school students included female (OR=0.263,95%CI:0.159-0.433),non-only children (OR=0.432,95%CI:0.257-0.727),and no family history of obesity (OR=0.138,95%CI:0.079-0.241). Sleep time more than 10 hours (OR=13.154,95%CI:1.468-117.850) was a risk factor for overweight and obesity in this area. Conclusions Malnutrition and obesity exist in middle school students in Ningxia Hui Autonomous Region. And the nutritional problems in boys and only children are more prevalent. Thus society,schools and families should adopt targeted interventions to reverse the unfavorable situation of the nutritional status

Investigation on the prevalence of malnutrition in primary and middle school students in Anhui province

LIU De-guo, LIU De-yun, WANG Qian, YANG Li-qi, LIU Yue

2019, 27(7):  793-796.  DOI: 10.11852/zgetbjzz2018-0635

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Objective To investigate the prevalence and distribution of malnutrition among middle school and primary school students in Anhui province,in order to provide reference for improving nutrition status of primary and middle school students. Methods Multi-stage cluster sampling method was applied in this research. A total of 9 980 students aged 7 to 17 years in three cities (Hefei,Chizhou,Suzhou) in north,middle and south of Anhui province were included in the investigation from September to November 2014. Data of students′ height and weight were obtained by physical examination. The prevalence rate was compared among children in different gender,age and areas groups. Results The prevalence rate of malnutrition among primary and middle school students was 13.25% in Anhui province in this investigation. The rates of stunting,slight wasting,moderate/severe wasting were 3.49%,5.61% and 4.16%,respectively. The prevalence rate of malnutrition of boys (14.65%) was significantly higher than that of girls (11.99%) (χ²=15.334,P<0.01). And the prevalence rate of malnutrition of students from rural area (15.10%) was significantly higher than that of students from urban area (11.28%) (χ²=31.608,P<0.01). Conclusions Malnutrition is prevalent in primary and middle school students in Anhui province,and the difference was significant among students from rural area and urban area. More attention and health education should be given to improve the nutrition status and promote the health of students

Prevalence trend of obesity among preschool children in urban areas of Qingdao

WANG Wen-yuan, ZHANG Meng-han, ZHAO Gui-lan, ZHANG Ting-ting

2019, 27(7):  797-799.  DOI: 10.11852/zgetbjzz2018-1171

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Objective To understand the prevalence of obesity among preschool children in urban area of Qingdao and the trends in recent years,so as to provide theoretical evidence for effective control and intervention of obesity. Methods A convenience sampling method was used to select 13 medium-sized kindergartens in Qingdao urban area from April to June in 2018.The height,weight,waist circumference and hip circumference of all children were measured.And the data were compared with those in 2006,in order to study the trend of obesity in preschool children for 12 years. Results The detection rate of obesity among children aged 3 to 6 years in this survey was 7.51%,which was significantly lower than that in 2006(9.52%,χ²=11.218,P=0.001),with annual decline of 16.75% on average.Also,the detection rate of obesity in boys(10.02%) was significantly higher than that in girls(4.80%,χ²=42.11,P<0.001).Likewise,the detection rate of overweight in children aged 3 to 6 years in 2018 was 15.85%,which was significantly lower than that in 2006 (18.12%,χ²=7.892,P<0.05).The BMI,waist-to-hip ratio and waist-to-height ratio of obese children were significantly higher than those of normal weight children (P<0.001). Conclusions The obesity in preschool children in Qingdao city has been effectively controlled over the past 12 years.Although the detection rate of overweight in children has decreased,it is still much higher than the detection rate of obesity.So it is suggested that preschool overweight children should be regarded as the key population to prevent and control the overweight children,in order to avoid its transformation into obesity in school age and adulthood.

Analysis of monitoring results of neuropsychological development in children aged 0-1 years in Beijing Dongcheng district from 2009 to 2016

WANG Dan, DAI Hong-wei

2019, 27(7):  800-802.  DOI: 10.11852/zgetbjzz2018-1067

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Objective To retrospectively analyze the neuropsychological development in children aged 0-1 years in Beijing dongcheng district from 2009 to 2016,and to evaluate the management model of children′s neuropsychological development monitoring,in order to provide reference for improving the psychological health care in children. Methods Children aged 0-1 years who took health care management in Dongcheng south district were enrolled in this study,and were monitored using the Denver Developmental Screening Test(DDST). Since 2015,an early warning screening method for children′s psychological and behavioral development has been added. Results The screening positive rate of developmental retardation rose from 1.94% in 2009 to 3.03% in 2016. The positive referral rate increased from 14% in 2009 to 65.57% in 2016. The prevalence rate of development delay significantly increased from 1.17‰ in 2009 to 8.78‰ in 2016. Conclusion The effective implementation of children′s neuropsychological development monitoring and health management model,is an effective way to early detection,early diagnosis and early intervention of children′s developmental delay

Analysis of distribution and trend of current smoking among middle and high school students in 12 schools in Haidian district from 2008 to 2016

SHEN Yan-hui, GUO Xin, LI Gang , PU Yong-lan, HUANG Na, LI Hai-sheng, JIANG Chu, SHEN Yuan

2019, 27(7):  803-806.  DOI: 10.11852/zgetbjzz2018-1125

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Objective To know about the distribution and trend of current smoking among middle and high school students in Haidian district,in order to provide reference for making effective interventions.Methods Using multi-stage cluster random sampling method,a total of 20 938 students had been surveyed with standard questionnaires,and the sample was 4 259,4 016,3 975,3 869 and 4 819 students in 2008,2010,2012,2014 and 2016,respectively. And 12 school doctors and one health inspector were interviewed about smoking policies of the schools,the interviewers observed and recorded the on-site information about cigarette stores and advertisements around the campus. Results The current smoking rate for middle and high schoolers in Haidian was 7.14%,with 3.11% for middle schoolers and 9.99% for high schoolers. The variance coefficients for middle schools and high schools were 82.18% and 106.56%,respectively.Vocational schools had higher rate of the smoking than common high schools(χ²=724.955,P<0.001). Common high schools and middle schools held greater smoking rates than corresponding middle schools and high schools(χ²=27.738,61.812,P<0.001). Among students in higher grade,the smoking rate was much higher (χ²=301.324,P<0.001). Male students were more likely to smoke than female students (χ²=415.147,P=0.001). Current smoking prevalence has declined in any of the three school types for male or female students. Current smoking rate for middle schoolers had decreased from 5.24% in 2008 to 1.05% in 2016(χ²=53.071,P<0.001),while it was from 13.53% to 5.74% for high schoolers (χ²=79.157,P<0.001). In the wake of the enforcement of No Smoking Campus policy in 2010,current smoking rate began to drop. But in 2012,the rate rebounded. Likewise,after the implementation of Controlling Smoking Act in 2015,the smoking rate fell again. Conclusions The smoking rate for middle and high schoolers in Haidian district has been decreasing. No Smoking Campus policy implemented in 2010 and Controlling Smoking Act in Beijing approved in 2014 might have contributed to the decrease