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    10 December 2019, Volume 27 Issue 12
    Medium and long-term effects of early language exposure on children's language development
    ZHANG Yi-wen
    2019, 27(12):  1277-1280.  DOI: 10.11852/zgetbjzz2019-1351
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    The influence of quantity and quality of early language exposure on children's language development is crucial.The quantity and quality of language input should be adjusted in a timely manner depending on children's developmental age.The quantity of parent's language input is the most important for children under 18 months old.The diversity and sophistication of words that parents produced,specifically the adult-child conversational turns,play a vital role for children at 30 months old.And the input of narrative and explanation utterances is principal for children at 42 months old.However,screen exposure and electronic(sounding) toys do more harm than good to children's language development and parent-child interactions.And children in low-educated families are particularly vulnerable to early screen exposure.
    Case-control study on the association between screen time and language delay in children aged 1 to 3 years
    WANG Sha-sha,TIAN Yuan,WANG Yu,CHEN Jin-jin
    2019, 27(12):  1281-1284.  DOI: 10.11852/zgetbjzz2018-1593
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    Objective To explore the association between screen time and infant language delay,in order to provide evidence for the prevention of language delay in infants. Methods A randomized sampling method was used to select 112 infants aged 18 to 46 months diagnosed with language delay in Shanghai Children's Hospital as case group from November 2017 to August 2018,meantime 66 healthy children matched by gender and age were selected as control group. A self-designed questionnaire on infant language delay and screen time was used to conduct this survey. Results There were no statistically significant differences on children's age,parents' occupation and whether parents were only child or not(P>0.05),while parents of control group had older age and higher educational level(P<0.05). However,mothers in case group had spent more time with their children on weekdays than mothers in normal group(t=-2.281,P=0.020). And the average screen time in case group was significantly longer than that in control group(t=-3.224,P=0.002). The content of screen in children was mainly animation,but the proportion of normal children watching science films was slightly higher than that of case group(χ2=11.558,P=0.009). In terms of limiting the screen time and having a rest after screen time more than 30 minutes,parents of normal children performed better than that of case group(χ2=6.962,11.034, P<0.05). Parents in case group allowed their kids to use video products more frequently than parents in control group(χ2=11.752,P=0.003). Mothers from case group spent more total time and leisure time on screen than mothers from control group(t=-2.920,-2.145,P<0.05). After controlling for confounding factors,it was found that children's screen time was an important factor affecting language development. For every one hour increase in children's screen time,the language development quotient decreased by 1.626. Conclusions Screen time is an important factor affecting children's language development. It is suggested to limit children's screen time every day in the family and parents should set an example to increase face-to-face emotional communication opportunities,thereby promoting children's early development.
    Analysis on the influencing for language development delay in children
    LIU Hui-yan,CHEN Zhen-zhen,CHEN Xiao-xia,ZHUO Mu-chun,SUN Jing,LI Wei-dong,LIN Sui-fang
    2019, 27(12):  1285-1287.  DOI: 10.11852/zgetbjzz2019-0244
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    Objective To explore the influencing factors for children with language development delay,in order to provide reference for preventing language development delay. Methods A case-control study was conducted on 248 children aged 1 to 6 years by questionnaire survey from October 2016 to June 2017,including 124 cases with language development delay and 124 normal control. The correlations between social demographic data,family environment,birth status,behavior and language development were analyzed.The S-S linguistic retardation assessment was adopted. Results Seven risk factors for language development in children were identified by Logistic stepwise regression analysis,including skip-generation raising(OR=3.391,95% CI:1.654-6.951),maternal education under senior high school(OR=5.186,95% CI:2.245-11.981),teaching with audio electronic toys or reading(OR=2.070,95% CI:1.122-3.817),screen time over 1 h/d(watching TV OR=2.305,95% CI:1.245-4.267;mobile phone and IPAD OR=3.246,95%CI:1.277-8.248),high-risk factors at birth(OR=2.253,95% CI:1.084-4.680) and during pregnancy(OR=2.575,95% CI:1.129-5.873). Conclusions The influence of family environment,rearing pattern and being exposed to electronic screen on children's language development should not be ignored.Avoiding risk factors and providing favorable language environment and scientific parenting views may help to prevent language delay in children.
    Association between relatively short stature and negative emotions in adolescents
    WU Yan,WANG Guang-hai,JIANG Yan-rui,LI Wen,DENG Yu-jiao,ZHU Qi, ZHANG Yun-ting,LIU Shi-jian,JIANG Fan
    2019, 27(12):  1288-1291.  DOI: 10.11852/zgetbjzz2019-1383
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    Objective To explore the association between relatively short stature and negative emotions in adolescents,and inform further psychological education and intervention. Methods From November 2017 to January 2018,multi-stage stratified cluster sampling method was used to randomly select 2 325 adolescents from 12 junior high schools and 12 senior high schools in 6 administrative regions of Shanghai for a survey of the self-reported Depression Anxiety and Stress Scale(DASS) and a parent-reported demographic questionnaire.Adolescents' stature data came from the physical examination data provided by the school. Results A total of 2 312 adolescents were available for the analysis,the mean age was(14.89±2.07) years,and 1 199(51.6%) were male.There were 145(6.27%) adolescents of relatively short stature(<P10),and in overall and each age group,no significant difference was noted in DASS total score,depression,anxiety and stress subscale scores from the normal height control group(t=0.27,-0.24,0.49,0.50,P>0.05).Adjusting for demographics,stature was not a significant predictor to negative emotions(P>0.05). Conclusion There is no significant association between relatively short stature and negative emotions in adolescents,and the contributing factors to negative emotions in adolescents of relatively short stature require further investigation.
    Study on the prognosis of asthma based on endothelial function-related multi-biomarkers
    ZHANG Wen-ting,HU Mei-hui,ZHANG Wei-lie,YI Yang
    2019, 27(12):  1292-1295.  DOI: 10.11852/zgetbjzz2019-0222
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    Objective To analyze the relationship between endothelial function-related biomarkersin serum of asthmatic children and the prognosis of asthma,so as to provide evidence for the assessment of asthma prognosis. Methods A total of 89 asthmatic patients aged 5-14 years in Changzhou Children's Hospital Affiliated to Nantong University were enrolled in this study from October 2016 to December 2017,and meanwhile 92 healthy children were selected in control group.Serum samples of the participants were collected for measurement of concentrations of vascular endothelial growth factor(VEGF),periostin,adiponectin(APN),leptin and inducible nitric oxide synthase(iNOS) activity using ELISA and other commercial kits.Serum concentrations of L-arginine,asymmetric dimethylarginine(ADMA) and symmetric dimethylarginine(SDMA) were measured by high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS).Children were followed up for one year,and the number of wheezing occurred in this period was recorded.Data were analyzed by orthogonal partial least squares-discriminant analysis(OPLS-DA) in order to screen endothelial function-related biomarkers that showed crucial influence on the prognosis of asthma. Results Serum levels of arginase I(Arg I),periostin,VEGF and leptin as well as iNOS activity significantly increased in asthmatic children,while L-arginine content decreased in children with asthma(P<0.05).The OPLS-DA model showed that asthma group and control group could be distinguished based on endothelial function-related multi-markers.The variable importance factor(VIP) values of Arg I,iNOS activity and VEGF were 2.11,1.23 and 1.09,respectively,indicating them as key endothelial function-related biomarkers for distinguishing asthma children from control group.Finally 70 children finished one-year follow-up.Compared with non-recurrent wheezing group(n=43),recurrent wheezing group(n=27) had increasing levels of serum ADMA and Arg I,as well as decreasing levels of periostin and APN(P<0.05).Both S-plot and VIP values of the OPLS-DA model indicated that APN,periostin,and Arg I were key endothelial function-related markers that could distinguish the two groups. Conclusions The homeostasis of vascular endothelial function-related markers is disrupted in the circulation of asthmatic children.APN,POSTN and Arg I have good predictive value for the prognosis of asthma in children.
    Case-control study on the non-inherited risk factors of congenital heart disease in newborn infants
    SU Cui-min,ZHANG Hui-yue,LIN Li-ping,HONG Yang-wen,ZHANG Yu-lin,SHI Jin-ju
    2019, 27(12):  1296-1299.  DOI: 10.11852/zgetbjzz2019-0176
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    Objective To explore the possible non-inherited risk factors of congenital heart disease(CHD) in newborn infants in Jinjiang city,so as to provide evidence for the prevention of CHD. Methods A 1∶2 matched case-control study was designed,in which 60 CHD cases were diagnosed by echocardiography in Jinjiang Municipal Hospital from January 2016 to December 2017,and 120 healthy children were selected as control group.A questionnaire survey was carried out retrospectively among parents of CHD cases and controls.Logistic regression analysis was conducted to filter suspicious risk factors of CHD in newborn infants. Results Among the 5 564 newborn infants born in Jinjiang Municipal Hospital from January 2016 to December 2017,60 CHD cases were confirmed(10.78‰) by echocardiography.Univariate Logistic regression analysis showed that the following factors were all significantly associated with CHD in newborn infants(P<0.05), including paternal alcohol consumption,maternal cold in early pregnancy, adverse pregnancy outcomes,maternal active smoking and exposure to passive smoke,accumulated time for using mobile phone,dwelling place nearby major traffic road.Multivariate Logistic regression analysis showed that high risk factors for CHD included maternal cold in early pregnancy(OR=17.84,95%CI:2.58-123.41),maternal active smoking and exposure to passive smoke in early pregnancy(OR=4.83,95%CI:1.82-12.79),paternal alcohol consumption before pregnancy(OR=6.20,95%CI:1.80-21.39),dwelling place nearby traffic road 50-100 m(OR=9.11,95%CI:2.99-27.73). Conclusions The development of CHD in newborn infants might be related to the exposure of various environmental risk factors.It is of great importance to understand those risk factors and strengthen health care in early pregnancy to prevent CHD.
    Research on the current status and influencing factors of electronic screen exposure in children aged 4 to 6 years in Shandong
    TENG Xiao-yu,DING Lei,SHAO Jing,YUAN An-xiang,SONG Jing,ZHANG Chun-guang,LI Ling, NIE Li-wei,LIU Xin,ZHAO Dong-mei,YANG Zhao-chuan,YI Ming-ji
    2019, 27(12):  1300-1303.  DOI: 10.11852/zgetbjzz2019-0026
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    Objective To understand the current status and influencing factors of electronic screen exposure in children aged 4 to 6 years in Shandong,in order to provide reference for appropriate use of electronic device. Methods A total of children in 20 kindergartens from 5 cities in Shandong province were selected by random sampling method from September to October 2018.The basic information,screen exposure conditions were investigated by questionnaires.Logistic regression model was used to analyze the influencing factors of screen time. Results The screen time of children aged 4-6 years on weekday was significantly lower than that in weekend [(1.40±1.48) h vs.(1.88±1.38)h,t=-15.411,P<0.05].The daily average screen time for boys and girls was (1.57±1.37) h and (1.50±1.24) h,and the difference was not significant(t=1.275,P=0.203).Multivariate analysis showed that medium proportion of breastfeedingwithin 4 months after birth(OR=1.462,95%CI:1.087-1.966),parents' frequent permission on using electronic devices(OR=3.806,95%CI:1.904-7.608),maternal education level under junior high school(OR=2.692,95%CI:1.397-5.188),parents'occasionally/sometimes/frequent restriction on screen content(OR=1.929,95%CI:1.326-2.807;OR=2.165,95%CI:1.611-2.911;OR=1.484,95%CI:1.167-1.887),longer daily screen time of parents(OR=1.069,95%CI:1.033-1.107) and the longer screen time of children before bedtime(OR=2.183,95%CI:1.740-2.740) were risk factors of daily average screen time≥1 h. Conclusions Excessive screen time is common among children aged 4-6 years and shows a lowering trend of age.Electronic screen exposure is affected by multiple factors,andchildren should be given scientific intervention and proper guidance.
    Comparatives study on clinical features of nocturnal enuresis children with different arousal levels
    XIONG Zhen,ZHANG An-yi,MA Jun
    2019, 27(12):  1304-1307.  DOI: 10.11852/zgetbjzz2019-0097
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    Objective To learn about the clinical features and the related influencing factors of nocturnal enuresis(NE) children with different arousal levels at night, so as to provide reference for individualized treatment. Method The clinical manifestations of 100 patients diagnosed with primary monosymptomatic nocturnal enuresis were investigated from June to September 2017 and descriptive statistical analysis was performed. Results There were 58 male cases and 42 females,and the age ranged from 5 to 16 years old,with an average age of (7.78±2.76) years old.The number of children with enuresis ≤3 times /week,4 to 7 times/week,8 to 14 times/week,and >14 times/week were 24(24%),49(49%),14(14%) and 13(13%),respectively.Most of nocturnal enuresis(36%) occurred at 11:00 PM to 12 PM,followed by 10:00 PM to 11:00 PM.The numbers of children waking up after a little bedwetting,bedwetting a lot and finish urination were 9(9%),9(9%) and 12(12%),respectively.Single factor analysis showed that hyperactivity,grinding teeth,and the teacher's criticism were related to the failure to wake up after enuresis(P<0.05).Multivariate Logistic regression analysis showed that hyperactivity was an independent risk factor for the failure to wake up after enuresis(OR=2.798,95%CI:1.034-7.572.). Conclusion When formulating the individualized diagnosis and treatment plan for children with enuresis,it is necessary to comprehensively consider the neuropsychological development and social environmental factors.
    Study on the spatial aggregation of birth defects in Xi'an
    ZHANG Li,XIANG Xiao-mei,ZHANG Shui-ping,YAN Hong,DANG Shao-nong
    2019, 27(12):  1308-1312.  DOI: 10.11852/zgetbjzz2019-0300
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    Objective To analyze the spatial aggregation of total birth defects,congenital heart disease,neural tube defects,cleft lip and palate in Xi'an,so as to provide evidence for making intervention measures. Methods Spatial analysis of birth defects was conducted.Spatial mapping was used to describe the spatial distribution of birth defects.The spatial aggregation of birth defects was analyzed using global and local Moran's I.Spatial statistical scan was used to analyze the aggregation and risk of birth defects. Results The incidence rates of total birth defects(333.56/104),congenital heart disease(68.51/104) as well as cleft lip and palate(49.66/104) in Chang'an district from October 1st,2009 to 30th September,2016 were the highest.The district with the highest incidence of neural tube defects was Lantian county(50.18/104).There was no global spatial autocorrelation of total birth defects,congenital heart disease,neural tube defects,as well as cleft lip and palate in Xi'an,but local spatial autocorrelation existed.The RR value of total birth defects was 1.60 in Baqiao district,Lantian county and Lintong district,1.10 in Beilin district,2.00 in Weiyang district and 4.14 in Chang'an district.The RR value of congenital heart disease was 1.96 in Beilin district,1.70 in Gaoling county,2.33 in Lantian county,1.86 in Weiyang district,and 3.13 in Chang'an district.The RR value of neural tube defects was 1.86 in Baqiao district,Gaoling county,Lintong district,Weiyang district and Yanliang district,6.00 in Lantian county,4.44 in Chang'an district.The RR value of cleft lip and palate was 1.65 in Baqiao district,Gaoling county,Lintong district,Weiyang district and Yanliang district,and 4.28 in Chang'an district. Conclusions There is no global spatial autocorrelation in birth defects in Xi'an,but local spatial autocorrelation exists.The birth defects in Chang'an district,Weiyang district,Beilin district and Baqiao district are higher than the average level in Xi'an.
    Comparative study on the effect of modified constraint-induced movement therapy versus hand-arm bimanual intensive therapy on the upper extremity function in children with hemiplegic cerebral palsy
    LIANG Yu-qiong,LI Xiao-jie,ZHU Lin
    2019, 27(12):  1313-1316.  DOI: 10.11852/zgetbjzz2018-1799
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    Objective To analyze the effect of modified constraint-induced movement therapy(mCIMT) versus hand-arm bimanual intensive therapy(HABIT) on the upper extremity function in children with hemiplegic cerebral palsy,in order to figure out the characteristics of mCIMT and HABIT. Methods A total of 30 children with hemiplegic cerebral palsy in the Third Affiliated Hospital of Jiamusi University were enrolled in this study from February to October in 2018,and were randomly divided into mCIMT group,HABIT group and control group,receiving mCIMT,HABIT,and conventional occupational therapy(OT) for 8 weeks,respectively.The Carroll Upper Extremities Functional Test(UEFT),Functional Independence Measure Children's Edition(WeeFIM),Peabody Developmental Motor Scales-Fine Motor(PDMS-FM) and Motor Activity Log-Amount of Use(MAL-AOU) were used to assess the children's function before and after intervention. Results The scores of UEFT,WeeFIM,PDMS-FM and MAL-AOU in the mCIMT group,HABIT group and control group after intervention significantly increased(P<0.05 or <0.01).And the scores of UEFT,WeeFIM,PDMS-FM and MAL-AOU in mCIMT group and HABIT group were significantly higher than those in the control group(F=6.75,7.01,23.91,21.17,P<0.01).Compared with mCIMT group,the scores of WeeFIM and MAL-AOU in HABIT group were significantly higher(P<0.01). Conclusions Both mCIMT and HABIT can improve the fine function and usage,bimanual coordination and functional independence of children with hemiplegic cerebral palsy.Moreover,HABIT is superior to mCIMT in terms of ipsilateral use and functional independence.
    Research progress on the treatment strategy of obesity related asthma in children
    SUN Liu-yu,QU Shu-qiang
    2019, 27(12):  1317-1319.  DOI: 10.11852/zgetbjzz2018-1737
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    Obesity and asthma are two important pediatric diseases all over the world. With the development of economy,the incidence of these two diseases has increased dramatically in recent years. Based on the clinical experience,the phenotype of obesity related asthma is confirmed by reviewing the relevant study. The characteristics of obesity related asthma are difficult to control,severe symptoms,insensitive to inhaled glucocorticoid,frequent attacks,lower quality of life than other phenotypes. Most current studies focus on the treatment of asthma,ignoring the effects of obesity. In addition to asthma treatment,children with obesity related asthma should also lose weight to alleviate the impact of obesity on asthma. This review is aimed to explore feasible treatment strategies for obesity-associated asthma in children.
    Recent advances on genetic and/or environmental factors of birth defects
    YU Min,ZHANG Shui-ping,LIU Chu-yang,YANG Jin,XIANG Xiao-mei,ZHU Zhan-fang
    2019, 27(12):  1320-1323.  DOI: 10.11852/zgetbjzz2018-1802
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    Birth defects refer to congenital abnormalities of embryos caused by chromosome aberration,gene mutation,or physical,chemical,biological and other environmental factors or gene-environment interaction. Influencing factors of birth defects have made rapid progress on both environmental and genetic factors. This review systematically introduces the influencing factors of birth defects as well as the latest research results and main points of view,in order to have a more comprehensive understanding of the causes of birth defects,thereby further proposing targeted preventive interventions.
    Factors affecting mental and physical development of preterm infants and the early interventions
    CHEN Xue-ting,SHEN Li-xiao
    2019, 27(12):  1324-1326.  DOI: 10.11852/zgetbjzz2018-1903
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    China is the second ranked country of preterm infants in the world, and the number of preterm infants is rising year by year.The increasing number of live born preterm infants makes the mental and physical development problems increasingly important.This review summarizes the factors affecting the mental and physical development of premature infants and the early interventions,thereby offering guide to child care physicians, early childhood education & rehabilitation institutions as well as parents for carrying out effective early interventions and bridging the gap with full-term infants at the same ageto the greatest extent possible.
    Review of methods for assessing mealtime behaviors in children with autism spectrum disorder
    ZHANG Peng-fei, LUO Yan
    2019, 27(12):  1327-1330.  DOI: 10.11852/zgetbjzz2019-0880
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    Due to the characteristics of autism spectrum disorder(ASD), the mealtime behavior of ASD children, compared with healthy contemporaries, often present extreme food selectivity, food refusal and rapid eating.It also includes unusually persistent preference for the traits and texture of certain foods and aggressive, self-injurious, ritual mealtime behaviors.These poor mealtime behaviors affect the intake of nutrients and the development of typical mealtime behaviors in children with autism.If mealtime behavior problems of children with ASD were discriminated and identified in time, it will be beneficial to rehabilitation and growth of children with ASD.A comprehensive, accurate, objective and detailed assessment of mealtime behavior problems can serve as a reference and basis for mealtime behaviors interventions and treatments for children with autism.Therefore, this review summarizes and elaborates on the assessment methods of ASD children's mealtime behaviors.
    Application of exercise prescriptions in the control of asthma
    TAN Jing,LIU Cheng-jun,HUO Jun-ming,LI Zhu-xia,LEI Yin-lan,SHU Chang,GAO Ya
    2019, 27(12):  1331-1334.  DOI: 10.11852/zgetbjzz2018-1804
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    Objective To understand the effect of exercise prescriptions on the condition control of asthmatic children,so as to provide evidence for the appropriate application of exercise prescriptions in the management of asthma in children. Methods A total of 156 asthmatic children in outpatient of Children's Hospital of Chongqing Medical University from June 2017 to June 2018 were enrolled in this study,and were randomly divided into exercise group(n=80) and control group(n=76).Both groups received medication therapy,and the exercise group was given exercise prescriptions additionally.After 3 months of intervention,related indicators were compared between the two groups,including the daytime and nighttime asthma symptom scores,the emergency medication score,the participation in physical activity and adverse reactions,the asthma quality of life scale score,and lung function changes. Results The daytime and nighttime asthma symptom scores,as well as the medication scores of the exercise group were significantly lower than those of the control group after exercise prescrispton(t=-3.25,-2.27,-26.69,P<0.05).While the asthma quality of life scale scores of the exercise group were significantly higher than those of the control group(t=3.39,22.44,4.50,P<0.05).There was no significant differences on lung function between the two groups except peak expiratory velocity(PEF) after exercise prescription(P>0.05).Moreover,no serious adverse reactions were observed in the exercise group during the trial. Conclusion Exercise prescription is safe and effective for the control of asthma in children,so it should be promoted and applied in clinical practice.
    Expression level and the clinical value of FeNO,total IgE and regulatory T cells of children with allergic asthma
    HAN Yu-min,SHI Na,WANG Yan,LIU Li-gang,ZHI Li-li
    2019, 27(12):  1335-1338.  DOI: 10.11852/zgetbjzz2019-0355
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    Objective To investigate the expression levels of exhaled nitric oxide(FeNO),total immunoglobulin E(IgE) and regulatory T cells(Treg) in allergic asthma children,and the clinical value of combined detection. Methods A total of 600 children with allergic asthma in Dongchangfu Maternal and Child Health Care Hospital were selected as the study group from March to November in 2018,and 100 healthy children at the same time were selected as control group.The levels of FeNO,total IgE and Treg were tested and compared between the two groups.The diagnostic efficacy of three separate detection methods and the combined detection for children with allergic asthma was calculated separately,and the diagnostic value was analyzed by ROC curve. Results The total IgE and FeNO levels in study group were significantly higher than those of the control group,while Treg level was lower than that in control group(P<0.05).The levels of FeNO and total IgE in peripheral blood were positively correlated with the severity of allergic asthma in children(r=0.562,0.591,P<0.05),while there was a negative correlation between Treg level and asthma severity(r=-0.569,P<0.05).The specificity of Treg for allergic asthma children was significantly higher than that of FeNO and total IgE(P<0.05).The sensitivity and negative predictive value of parallel combined detection were significantly higher than those of the single test and serial combination test(P<0.05).The specificity and positive predictive value of the serial combined test were significantly higher those of the parallel combined test(P<0.05).The areas under the curve for parallel and series combined detection of FeNO,total IgE,Treg were 0.938 and 0.917,respectively. Conclusions FeNO,total IgE and Treg levels in children with allergic asthma are associated with the severity of asthma and the severity of asthma.The diagnostic value of allergic asthma in children can be improved by parallel combined detection or serial combined detection of the three indicators.
    Analysis of thalassemia gene detection in children attending physical examination in Chengdu area
    YU Xia, LIU Cheng-gui, SHEN Wei, YANG Lian, LIAO Zhi-yong, LIU Rui,ZHU Jing
    2019, 27(12):  1339-1341.  DOI: 10.11852/zgetbjzz2019-0227
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    Objective To analyze the gene carrying rate and genotype of thalassemia in children undergoing physical examination in Chengdu,so as to provide basis for formulating preventive measures against thalassemia in this area. Methods A retrospective analysis was made on the results of blood routine test and thalassemia gene test in 8 327 children who underwent nursery examination in Chengdu Women & Children's Central Hospital from January 2017 to June 2018. Results A total of 423 cases(5.07%) of small cell hypochromic anemia were detected in 8 327 children.And 158 cases(1.90%) were diagnosed with thalassemia by gene testing,of which 64 cases(40.51%) were diagnosed with alpha-thalassemia,with the highest detection rate of --SEA/αα(29.75%).And 94 cases(59.49%) were diagnosed with beta-thalassemia,with the highest detection rate of CD41/42(-TCTT)(34.18%). Conclusion Prevention and control of thalassemia in Chengdu mainly focus on preventing the birth of Parkinson's edema fetus and severe beta-thalassemia children,and take corresponding measures to reduce the carrying rate of thalassemia.
    Detection and clinical significance of Cys LTs,MCP-4 and MDC in peripheral blood of asthmatic children
    HU Xiao-jing,WU Xiao-juan,LIU Wen-dong,LIU Xiu-qin
    2019, 27(12):  1342-1344.  DOI: 10.11852/zgetbjzz2019-0088
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    Objective To investigate the levels of cysteinyl leukotrienes(Cys LTs),monocyte chemoattractant protein-4(MCP-4) and macrophage-derived chemokine(MDC) in peripheral blood of asthma children,in order to explore their value in clinical assessment of asthma. Methods Totally 220 children were enrolled in this study from June 2016 to June 2018,including 48 cases in asthma attack group,52 cases in asthma remission period,64 pneumonia children and 56 healthy children.Serum levels of Cys LTs,MCP-4 and MDC in each group were compared. Results Serum levels of Cys LTs,MCP-4 and MDC in acute stage of asthma were significantly higher than those in remission stage, pneumonia group and normal control group(P<0.05).There was no significant difference on serum levels of Cys LTs,MCP-4,MDC between pneumonia group and asthma remission group(P>0.05),which were significantly higher than those in normal control group(P< 0.05).The levels of Cys LTs,MCP-4 and MDC in peripheral blood of children with different severity categories of asthma were significantly higher than those of normal control group(P<0.05).Pearson analysis indicated that there were positive correlations between the levels of Cys LTs and MCP-4,MDC and MCP-4,Cys LTs and MDC(r=0.865,0.812,0.893,P<0.01). Conclusions Cys LTs,MCP-4 and MDC are involved in many aspects of asthma. Cys LTs,MCP-4 and MDC in peripheral blood have important clinical value in the assessment of asthma in children.
    Effect of intrauterine growth retardation on the growth of premature infants
    ZHANG Yong,WANG Zhao-hui,LI Yan-hui
    2019, 27(12):  1345-1348.  DOI: 10.11852/zgetbjzz2019-1241
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    Objective To explore the influence of intrauterine growth retardation(IUGR) on physical development of premature infants,in order to provide scientific reference for early intervention. Methods A total of 449 preterm infants born in Xi'an Fourth Hospital from 2015 to 2017 and filed in Healthcare Center of Children were selected as observation group,of whom 91 cases were small for gestational age(SGA) newborns and 358 were appropriate for gestational age(AGA) infants.Meanwhile,300 full-term neonates were randomly selected as the control group.The physical development monitoring and individualized feeding guidance for three groups of children were followed up to corrected gestational age of 12 months old.The difference on the developmental delay(DD) rate between SGA group and AGA group was analyzed,and the growth rate of three groups of children was compared. Results 1) There was significant difference on the incidence of DD regarding body weight,length,and head circumference of premature infants among different age groups,which decreased with the increasing of age(χ2SGA=24.242,46.761,9.891,P<0.05;χ2AGA=17.536,45.763,13.829,P<0.05);2) The rate of DD on body weight,length,and head circumference between SGA and AGA infants at the same age was significantly different(P<0.05).3) The growth rate within corrected age of 6 months old among SGA group,AGA group and full-term infant group was significantly different(P<0.05). Conclusions Preterm infants show catch-up growth after birth,and SGA preterm infants appears to have the strongest catch-up trend.However,20% of SGA preterm infants still have physical retardation at the age of one year old.
    Analysis on immune surveillance of children born to mothers infected with hepatitis B virus in Changsha
    ZHANG Ai-ping,KUANG Xiao-ni,FAN Xiao-lan,WANG Jin-lian
    2019, 27(12):  1349-1350.  DOI: 10.11852/zgetbjzz2019-0166
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    Objective To understand the immune status of children born to hepatitis B virus(HBV)-infected mothersin Changsha,so as to further provide evidence for formulating interventions. Methods Mother to child blocking of HBV was conducted in infants born to permanent HBV-infected mothers in Changsha from April 1st,2017 to September 30th,2018.After finishing hepatitis B vaccination at the age of 0,1 and 6 months,the levels of surface antigen,surface antibody,E antigen,E antibody and core antibody of hepatitis B were tested. Results The injection rate of hepatitis B immunoglobulin in children born to HBV-infected mothersin Changsha was 99.9%(6 492/6 498).And 1 533 children conducted related indexes of hepatitis B.It was found that the rate of mother-to-child transmission of hepatitis B was 1.44 %,and the positive conversion rate of hepatitis B surface antibodies was 80.8%,with significant difference between urban and rural areas(χ2=7.022,32.497,P<0.05). Conclusions The prevention of mother-to-child transmission of HBV in Changsha has achieved remarkable results.Government is supposed to establish a regular monitoring information mechanism for HBV exposure,so that some children who have successfully blocked the prevention of hepatitis B surface antibodies without developing hepatitis B surface antibodies can be immunized in a timely manner,thereby avoiding infection,and further reducing the regional hepatitis B infection rate.
    Effect ofChina Children Asthma Action Plan on clinical management of children with bronchial asthma in Baoding area
    WANG Hui,HUANG Qiu-fang,ZHANG Li-hong,REN Ming
    2019, 27(12):  1351-1354.  DOI: 10.11852/zgetbjzz2019-0046
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    Objective To observe the clinical management and safety of China Children Asthma Action Plan(CCAAP) in children with bronchial asthma. Methods A total of 64 children with bronchial asthma in the Pediatric Department of Baoding First Central Hospital from October 2017 to October 2018 were enrolled in this study,and were randomly divided into two groups by random number table method. The observation group(n=34) was managed by CCAAP,while the control group(n=30) received traditional management.The efficacy,pulmonary function,immune function and side effect of two groups were compared. Results Compared with the control group,the treatment effect of the observation group was better(97.06% vs.80.00%,χ2=4.761,P=0.029).The forced expiratory volume in 1 second(FEV1),FEV1/forced vital capacity(FEV1/FVC),FEV1/pred,25% of the maximal mid-expiratory flow(MEF25),MEF50,MEF75,CD3+,CD4+ and CD4+/CD8+ were significantly higher than those in control group,while the IgE and IL-4 levels decreased(P<0.05).Moreover,the rates of acute attack(14.71% vs.50.00%) and complications(2.00% vs.10.00%) in the observation group were significantly lower(P<0.05). Conclusion The CCAAP can improve the efficacy and safety of bronchial asthma in children and help improve pulmonary function and immune function.
    Study on the level ofpulmonary function test in children with asthma and the clinical significance
    LIU Jin,SHAO Jing-xian,ZHOU Wen-di
    2019, 27(12):  1355-1357.  DOI: 10.11852/zgetbjzz2019-0297
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    Objective To observe the levels of FEV1,FVC and FEV1/FVC in children with asthma,and to analyze the correlation with cytokines and immune function. Methods A total of 100 children with asthma who were treated in the First People's Hospital of Huaian City from August 2015 to August 2018 were enrolled as asthma group,and 100 non-asthmatic children at the same period were selected as control group.The levels of FEV1,FVC,FEV1/FVC,cytokines and immune function of the two groups were tested,and the correlation among the levels of FEV1,FVC,FEV1/FVC,cytokines and immune function were analyzed. Results The levels of FEV1,FVC,FEV1/FVC,CD3+,CD4+ and CD8+ in asthma group were 78.47±2.13,80.23±2.76,75.68±1.05,61.09±2.43,43.15±3.0 and 21.83±2.27,respectively,significantly lower than those in control group(t=-40.376,-37.674,-56.508,-11.175,-14.530,-34.348,P<0.001).However,the levels of IL-4,IL-5 and IL-13 in asthma group were 156.63±10.14,55.26±3.45 and 57.54±4.16,respectively,which were significantly higher than those in control group(P<0.05).The levels of FEV1,FVC and FEV1/FVC in asthmatic children were negatively correlated with the levels of cytokines(IL-4,IL-5 and IL-13)(r=-0.552--0.358),positively related to the indexes of immune function(r=0.398—0.514). Conclusion The levels of FEV1,FVC and FEV1/FVC in asthmatic children are low,and closely related to cytokines and immune function.
    Evaluation of the therapeutic effect of fluticasone propionate inhaled with a spacer in children with acute bronchiolitis
    XI Lei,WANG Ya-jun,LU Xu
    2019, 27(12):  1358-1361.  DOI: 10.11852/zgetbjzz2019-0478
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    Objective To compare the effect of inhaled fluticasone propionate with a spacer and atomization inhalation budesonide suspension on the prognosis of children with acute bronchiolitis. Methods A total of 187 infants diagnosed with bronchiolitis in Tongzhou Maternal and Child Health Hospital of Beijing from September 2016 to June 2018 were enrolled in this study and were randomly divided into fluticasone treatment group(67 cases),budesonide treatment group(63 cases) and control group(57 cases).Fluticasone treatment group received inhaled fluticasone propionate with a spacer,budesonide treatment group was given atomization inhalation budesonide suspension,and the infants in control group did not receive any inhalation of corticosteroids after hospital discharge.All children were followed up for 1 month,and lung function and the fractional exhaled nitric oxide(FeNO),the recurrent wheezing times were compared before and after the follow-up. Results The number of children who completed follow-up in fluticasone treatment group,budesonide treatment group and control group was 67,62 and 56 cases,respectively.After the intervention,the ratio of time to peak tidal expiratory flow to total expiratory time(TPTEF/TE) and ratio of volume to peak expiratory flow to total expiratory volume(VPEF/VE) were significantly higher than those before intervention(P<0.05),but the FeNO was significantly lower than that before intervention(P<0.05).The number of children with recurrent wheezing in the two groups was significantly lower than that in the control group,but the difference was not significant(P>0.05). Conclusions Inhaled fluticasone propionate can effectively prevent and treat the relapse of cough and wheezing after bronchiolitis in the short term,reduce the airway inflammation and improve the lung function.The way of inhale corticosteroid with a spacer is so handy that it can replace aerosol inhalation to improve the prognosis of bronchiolitis.
    Clinical significance of pulmonary function detection in children with mycoplasma pneumonia
    WANG Xiu-ping,TIAN Fu-xiang
    2019, 27(12):  1362-1364.  DOI: 10.11852/zgetbjzz2019-0172
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    Objective To analyse the changes and clinical significance of pulmonary function in children with mycoplasma pneumoniae pneumonia(MPP) during acute and convalescent periods. Methods A total of 60 children aged 3 to 10 years with acute MPP in Yan'an People's Hospital were selected as observation group from June 2015 to June 2017,and 60 healthy children were selected as control group at the same time.All children took routine pulmonary function test,and the observation group was followed up to the recovery period(on the third weeks after the onset). Results The indexes of pulmonary function ventilation(FVC,FEV1,FEV1/FVC,PEF,MEF75,MEF50,MEF25,MMEF) in the acute stage of MPP were significantly lower than those in normal control group(t=-6.719,-6.835,-1.754,-6.171,-6.926,-5.661,-6.889,-6.874,P<0.05).And all indexes in the recovery period obviously increased than the acute stage.Compared with the normal control group,FVC,FEV1,FEV1/FVC and PEF in the recovery period of MPP children recovered basically,while MEF75,MEF50,MEF25 and MMEF were still lower(t=-2.306,-1.995,-3.305,-2.557,P<0.05). Conclusions The pulmonary function of MPP children have different degrees of damage in the acute stage.All the indexes of large airway in the recovery period are basically recovered,but the indexes of small airway still not rise to the normal level.Therefore,it is necessary to dynamically monitor lung function in clinical practice,which is of great significance in the evaluation and prognosis of treatment of MPP children.
    Study on the cut-off point of refractive screening in children aged 6 months to 6 years
    WU Guang-qiang,WEI Ning,WU Xing-xiang,XIANG Si-jia,WANG Qin,TONG Mei-ling
    2019, 27(12):  1365-1367.  DOI: 10.11852/zgetbjzz2019-0351
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    : Objectives To analyze the outcome of Welch Allyn spot VS100 in testing for children aged 6 months to 6 years,and to determine the cut-off point of each age group. Methods Totally 15 342 children aged 6 months to 6 years were enrolled in this study from March to September in 2018 and conducted refractive screening by Spot VS100.Statistical descriptions and analysis were conducted by age to determine the cut-off points for each group. Results The x-±2s of spherical equivalent and P95 of cylinder in 6 to 12-month-old children,1 to 3-year-old children and 3 to 6-year-old children were -1.50 D —+2.00 D,2.75 D;-1.25 D —+1.75 D,2.00 D;and -0.75 D —+1.25 D,1.25 D,respectively.The absolute value of cylinder gradually decreased with increasing age (H=739.449,P<0.059),while the constituent ratio of emmetropia increased with the increasing age of children(χ2=585.048,P<0.01). Conclusions The results of refractive screening for children aged 6 months to 6 years should be judged according to their age.Children wih spherical equivalent deviating out of x-±2s and cylinder deviating over P95 should be seen as high-risk of amblyopia and be given further examinations.
    Analysis on collective children's physical condition in kindergartens of Rongcheng city from 2012 to 2017
    TIAN Juan-juan,CAI Jing,YU Hua-xiu,JU Xiao-hua
    2019, 27(12):  1368-1370.  DOI: 10.11852/zgetbjzz2018-1829
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    Objective To find out the changing trend of children's physical condition in Rongcheng city from 2012 to 2017,so as to provide scientific basis for developing interventions. Method By longitudinal and horizontal comparison,the health examination data of children in 26 kindergartens in Rongcheng city was reviewed and compared. Results The prevalence rate of malnutrition(low weight,stunted growth,marasmus) and anemia were low,ranging from 0.45% to 0.52%,0.89% to 1.19%,respectively.There was no statistically significant difference on the prevalence rate of malnutrition and anemia(χ2=0.366,2.123, P>0.05).Childhood obesity rate increased from 4.75% in 2012 to <5.14% in 2017(χ2=0.921, P>0.05).Subnormal vision rate increased from 10.55% in 2012 to 19.29% in 2017,and the prevalence rate of dental caries ranged from 33.22% to 36.29%,with significant difference year by year(χ2=176.935,42.363, P<0.01 or <0.05).Moreover,the prevalence rates of dental caries,anemia and subnormal vision in public kindergartens were lower than those in private kindergartens(χ2=71.226,13.715,109.617,P<0.01). Conclusions Children in kindergartens of Rongcheng city are in good health.Obesity and abnormal vision are the key points of intervention.Meanwhile,oral health care should not be ignored,and health care work in private childcare institutions needs to be further strengthened.
    Study on the consistency of transcutaneous bilirubin measurements and serum total bilirubin measurements during phototherapy by Bland-Altman analysis
    SUN Li-ping,WANG Zhu-heng,ZHANG Xia,DI Jian-hui,GAO Cui-min
    2019, 27(12):  1371-1373.  DOI: 10.11852/zgetbjzz2018-1272
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    Objective To determine whether transcutaneous bilirubin measurements(TcB) before and during phototherapy consist with total serum bilirubin(TSB) levels,in order to provide reference for the bilirubin monitoring during phototherapy. Methods A prospective observational study was conducted on full-term neonates requiring phototherapy and TSB measurements from March 2017 to May 2018.TcB measurement was collected within 3 minutes of blood for TSB measurements.The consistency of TcB and TSB was analyzed by Bland-Altman method. Results A total of 239 neonates were included,with the gestational age of (38.3±1.2) weeks and birth weight of (3.1±0.23)kg.Before starting phototherapy,the levels of TSB and TcB were (221.3±32.8) μmol/L and (227.5±33.9)μmol/L,respectively.During phototherapy,the levels of TSB and TcB were (188.6±35.2) μmol/L and (185.9±32.6) μmol/L,respectively.The Bland-Altman analysis demonstrated that before starting phototherapy the mean difference between TSB and TcB was (6.7±21.4) μmol/L (95% CI:-27.9-41.2)μmol/L,which was(-2.7±20.7)μmol/L (95% CI:-42.4-37.1)μmol/L during phototherapy. Conclusion The consistency between TcB measurement and TSB measurement is satisfying,indicating that both of them can be used to monitor bilirubin levels during phototherapy in jaundiced term infants.
    Etiological study and therapeutic management of children with chronic wet cough in Qingdao area
    WANG Li-yan,SUN Guang-rong,LIU Tian-tian,WANG Xiao-li
    2019, 27(12):  1374-1377.  DOI: 10.11852/zgetbjzz2019-0093
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    Objective To understand the etiology,clinical features and therapeutic management of children with chronic wet cough in Qingdao area,in order to provide clinical basis for standardization and normalization of the diagnosis and treatment of chronic wet cough. Methods According to the 2013 Guidelines for diagnosis and treatment of chronic cough in children revised by Chinese Medical Association,726 children diagnosed with chronic wet cough in Cough and Asthma Clinic of Qingdao Women and Children's Hospital were selected from July 2017 to July 2018.The data were statistically analyzed and the constituent ratio of causes and treatment of chronic cough were obtained. Results 1) The leading 5 causes of chronic wet cough in 726 children included upper airway cough syndrome(UACS,47.1%),post-infectious cough(PIC,24.7%),protracted bacterial bronchitis(PBB,7.85%),asthma with infection(6.74%) and gastroesophageal reflux cough(GERC,5.23%).2) The etiological composition in children at different age groups was different,and the onset time,appearance of sputum and cytological analysis were different.3) The correction rate of main diagnosis and multiple causes was as high as 55.55%,mainly with combined treatment.Combined treatment of 3 to 4 drugs in the first visit accounted for 45.31%. Conclusions 1) The etiology of chronic wet cough in children in Qingdao is different from that of chronic cough.2) Because of the lack of standardized management and high proportion of modified diagnosis,more attention should be paid to the clinical efficacy of chronic wet cough.In addition,for cases with more causes and unknown etiology,it is necessary for clinical staff to give more concern,revise the diagnosis and adjust the medication timely according to the principles of observation and follow-up.
    Analysis of rehabilitation effect of suspension exercise training system on athetoid cerebral palsy
    LIN Hong
    2019, 27(12):  1384-1387.  DOI: 10.11852/zgetbjzz2018-1813
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    Objective To study the rehabilitation effect of suspension exercise training system on athetoid cerebral palsy,in order to provide scientific reference for clinical treatment. Methods A total of 42 children with athetoid cerebral palsy treated in Jingzhou Maternal and Child Health Care Hospital from August 2015 to August 2017 were selected as the participants,and were randomly divided into observation group and control group using digital randomization method,with 21 cases in each group.The control group received routine rehabilitation treatment,while the observation group was treated with the suspension exercise training system additionally for 3 months.Berg Balance Scale(BBS) and Gross Motor Function Measure(GMFM) were used to evaluate the balance and gross motor function of children in two groups.The step size,step width and 10 m maximum walking speed(MWS) were recorded to evaluate walking ability.The effects of different age and gross motor function grading system(GMFCS) grading on walking ability were analyzed. Results There was no significant difference on GMFM score and BBS score between observation group and control group before treatment(P>0.05).After treatment,GMFM score and BBS score both increased in the two groups,and were higher in observation group than that in control group(t=4.767,3.543,P<0.01).Likewise,the difference on the scores of walking ability was not significant before treatment between two groups(P>0.05).After treatment,the stride width significantly decreased,while the step size and MWS significantly increased.And the step size and MWS of observation group were significantly higher than that of control group after treatment(t=4.767,3.985,4.221,P<0.01).There were significant differences on step width,step size and MWS between different age and GMFCS grade groups(age:t=3.986,2.878,2.986,P<0.001;GMFCS grade:t=4.043,4.173,3.875,P<0.001). Conclusions Suspension exercise training system based on the basis of conventional rehabilitation therapy can improve the large exercise and balance ability of children with athetoid cerebral palsy,increase the pace and step length, reduce the walking width,and significantly improve the rehabilitation effect.At the same time, the age of children and GMFCS classification have influence on the treatment effect.