Table of Content

10 September 2020, Volume 28 Issue 9

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Responsive feeding in infant and young child nurturing care

XU Pei-bin, YIN Chun-lan

2020, 28(9):  955-957.  DOI: 10.11852/zgetbjzz2020-1090

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Except for the amount and type of food,researchers are increasingly aware of this,unresponsive feeding is a major barrier to health and nutrition.For this,responsive feeding is promoted in the feeding guidelines of WHO and UNICEF.This paper focuses on the scope,challenges,implementation plan,promotion strategy and effect monitoring of responsive feeding to promote the development of responsive feeding in infant care.

Prospective cohort study on the influence of early parent-child interactionon the sociality performance of infants under one year old

YUAN Lin-lin, SHI Hui-jing, ZHANG Yu-di, JIANG Zi-han, QI Yue, ZHANG Yun-hui

2020, 28(9):  958-961.  DOI: 10.11852/zgetbjzz2019-1646

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Objective To analyze the effects of early parent-child interaction at 1.5―2 months on the sociality performance of infants at the age of 6 and 12 months old,so as to provide scientific guidance for promoting early child development. Methods Mothers and infants who were followed up for 1.5―2 months,6 months and 12 months old till January 2019 were enrolled in this study.The parent-child interaction behavior was evaluated at the age of 1.5 to 2 months old,and the sociality performance of infants was evaluated at the age of 6 months and 12 months old. Results Univariate analysis showed that the early parent-child interaction scored lower in groups of maternal delivery age≥35 years old,postpartum depression,premature birth and low birth weight(P＜0.05).Multivariate Logistic regression analysis showed that less early parent-child interaction was a risk factor for the overall dysplasia of sociality performance in infants aged 6 months[responding to people and things(OR=1.36,95% CI:1.06―1.75),the game reaction(OR=1.39,95% CI:1.08―1.78) and autonomous movement(OR=1.49,95% CI:1.12―1.99)].Moreover,less early parent-child interaction was a risk factor for the overall dysplasia of sociality performance in infants aged 12 months[responding to people and things(OR=1.46,95% CI:1.05―2.04) and autonomous movement(OR=1.52,95% CI:1.09―2.13)]. Conclusion Less early parent-child interaction at 1.5 to 2 months old significantly increase the risk of sociality performance dysplasia in infants at the age of 6 months old,and this impact will continue to affect the development of infants at the age of 12 months old.

Cross-sectional study of parenting difficulties in children aged 3 to 5 years in urban China

LI Wen-hao, ZHANG Yue, YANG Jin-liu-xing, FENG Wei-wei, TANG He

2020, 28(9):  962-966.  DOI: 10.11852/zgetbjzz2020-1358

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Objective To support the child-health medical staffs give targeted parenting guidance, by surveying the parenting problems in parents of preschool children in urban area of China. Methods In 2017, the parenting survey was conducted among 2 286 parents of 3-5 years old children in 15 cities, 14 provinces across the country. The parenting survey was about the social demographic status, the parenting problems and the severity of each specific problems. Chi-square test and Logistic regression were used to analyze the influence of social demographic factors on the serious parenting difficulties. Results 92.9% of parents reported experiencing more than one parenting problems and 3.7% of parents encountered at least 3 parenting difficulties which was very difficult to deal with. Parents reported that the incidence of specific parenting problems among 3-5 years old children was between 52.48% and 13.91%. The most common problems were "picky eating"(52.48%), "not eating by herself/himself"(49.66%), "sleep problems"(46.54%) and "disobey"(46.07%). Logistics regression analysis showed that boys(OR=1.25,95%CI: 1.02-1.53) was the risk factors for parents to report serious parenting difficulties, while elder children(OR=0.84,95%CI: 0.75-0.95), mother′s age at delivery(OR=0.96,95%CI: 0.93-0.99) and nuclear family(OR=0.77,95%CI: 0.61-0.97) were the protective factors. Conclusions Parents of children aged 3-5 years old in urban China are generally faced with parenting problems. It is necessary to provide universal and professional parenting support for parents. The medical staffs should provide parents with feeding, sleeping and behavioral support, especially to the parents with young children, boys, young mothers, and non-nuclear families.

Prevalence and determinants of suspect developmental delay in Warning Sign for Children Mental and Behavioral Development screening among children under 3 years old in rural China

ZHOU Sui-zan, ZHANG Jing-xu, WANG Xiao-li

2020, 28(9):  967-970.  DOI: 10.11852/zgetbjzz2019-1713

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Objective To analyze prevalence and determinants of suspect developmental delay (SDD) in Warning Sign for Children Mental and Behavioral Development (WSC-MBD) checklist screening among children under 3 years old in rural China,so as to provide evidence for resource allocation for referral and intervention services,as well as the prevention strategy development. Methods A community based cross-sectional study was conducted from July to September 2016 in two poverty counties in Guizhou and Shanxi provinces separately. Cluster sampling by village was used to select children aged <3 years old and ≥ 3 months old. Age appropriate WSC-MBD was used by face-to-face interview with caregivers of children to detect SDD. Chi-square test and Logistic regression were used to examine the determinants of SDD. Results Total 1 298 children were enrolled,of whom 89(6.9%) children were preterm infants,341(26.3%) children with per capita net income of family less than 2 300 RMB/year,and 559(43.1%) were left-behind. Among all children,126(9.7%) children were detected with SDD,although 71.4% of SDDs were mild with only one abnormal warning sign out of 4 signs in total. Both the univariate and multivariate analysis suggested preterm birth was associated with higher risk of SDD (adjusted OR=2.193,95%CI:1.225-3.927). The prevalence of SDD deceased along with the increase of month age within the same WSC-MBD group (adjusted OR=0.823,95%CI:0.701-0.967). Conclusions WSC-MBD is feasible to detect SDD among children in rural China. The risk of SDD is associated with preterm birth,and sensitive to the small month age difference within the same WSC-MBD group.

Research on the characteristics of graphic naming ability of children aged 3 to 6 years in Shanghai

DING Zhong-bing, ZHANG Yun-shu, BAI Yin-ting, LIU Jie, HUANG Zhao-ming

2020, 28(9):  971-974.  DOI: 10.11852/zgetbjzz2020-0858

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Objective To investigate the graphic naming development ability of children aged 3 to 6 years in Shanghai,so as to know about the general rules of graphic naming ability. Methods According to the principle of stratified cluster sampling,781 children aged 3~6 years in Shanghai were tested with the graphic naming test module of Dr.Brain-1 in March 2018.And the difference among children in different age and gender groups was compared using multivariate analysis of variance. Results 1) There was very significant difference on the scores of flat graphics and three-dimensional graphics in children at different age groups (P<0.01),but the difference was not significant between boys and girls (P>0.05),and there was no interaction effect between age and gender (P>0.05).2) Children scored higher in naming flat graphics than three-dimensional graphics.3) In terms of naming order of flat graphics,children first learned round,five-pointed star and heart shape,and finally learned parallelogram and regular hexagon.4) In terms of naming order of three-dimensional graphics,children first learned spheres,cubes and cuboids,and finally learned cylinders and cones. Conclusion There is a difference on the development of the graphic naming ability of children aged 3 to 6 years between children at different age stage groups,and there is a specific acquisition order,which can provide reference for normal children′s graphic learning and early screening and intervention of children with graphic cognitive impairment,thereby promoting the comprehensive and balanced development of children′s cognitive abilities.

Study on the association between physical activity and executive function in preschoolers

QU Xiao, WANG Xiao-juan, WANG Bo, FENG Chao, GUAN Hong-yan, CHEN Xiao-bo

2020, 28(9):  975-979.  DOI: 10.11852/zgetbjzz2019-1873

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Objective To know the physical activity condition in preschoolers,and to investigate the association between physical activity and executive function. Methods From May to July in 2018,201 children of middle class in 3 kindergartens in Beijing were recruited using convenience sampling. Participants were asked to wear ActiGraph GT9X for 3 days. Children′s executive function,including inhibition,shift and working memory,were tested through Early Years Toolbox (EYT). Screen time was investigated by self-compiled questionnaires. Results The average time of moderate to vigorous physical activity and total physical activity per day were (95.65±29.02) minutes and (204.58±46.91) minutes,respectively. There were significant differences between boys and girls on the time for mild,moderate,vigorous,moderate to vigorous and total physical activity per day (U=2 593.00,2 136.00,2 440.00,t=4.09,3.68,P<0.05). Screen time per day was (72.84±51.79) minutes,and there was no significant difference between boys and girls (P>0.05). The average scores of working memory,inhibit and shift were 2.40±0.80,0.76±0.16 and 14.08±3.49,respectively,and there was no difference between boys and girls (P>0.05). Correlation analysis indicated that of shift test score was correlated with vigorous intensity physical activity (r=0.199,P=0.040). Children were divided into different groups by whether they met the guidelines criteria of screen time,total physical activity and moderate to vigorous activity,and it was found that there was no difference on EYT score between different groups (P>0.05). Conclusions Daily physical activity is insufficient among preschoolers. Besides,there is a correlation between executive function and physical activity,and the association was influenced by physical activity intensity.

Diversity of intestinal flora in children with autism spectrum disorder

WU Wei-lan, JIANG Hui-yun, CHEN Xue, ZHU Cai-rong, CHEN Wei-ping, LIU Xin

2020, 28(9):  980-984.  DOI: 10.11852/zgetbjzz2019-1045

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Objective To analyze the structure and diversity of intestinal flora in children with autism spectrum disorder (ASD). Methods The number of 20 children with ASD diagnosed in Maternal Child Health Hospital of Guangxi Autonomous Region and the number of 20 healthy children from January to June 2018 were selected as the subjects in the study.Total DNA was extracted from feces of two groups of children,and V4/V5 region of 16S rDNA was amplified for high throughput sequencing.The intestinal flora diversity of ASD children was analyzed by sequencing results. Results There were no significant differences in the coverage of sample libraries (Z=242.500,P=0.256),abundance index Chao1 (Z=250.000,P=0.181),ACE (Z=234.000,P=0.365),Shannon (Z=259.000,P=0.114) and Simpson (Z=146.000,P=0.145) indices between the two groups (P>0.05).At the gate level,there was no significant difference between the two groups in 8 species of bacteria (P>0.05),but at the generic level,there was significant difference between the two groups in 20 genera (P<0.05). Conclusions There are differences in intestinal flora between ASD children and healthy children.In clinic,the intestinal flora of ASD children can be accurately adjusted according to the characteristics of different bacteria genus to maintain the intestinal microecological balance and alleviate the gastrointestinal symptoms of ASD children.

Study on the methylation of ENO2 gene in peripheral blood in children with autism spectrum disorder

JIANG Lian, MA Chen-huan, FANG Yu-dan, WEI Nian-jin, CHEN Feng-feng, PAN Li-zhu, WANG Yu

2020, 28(9):  985-988.  DOI: 10.11852/zgetbjzz2019-1920

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Objective To explore the methylation modification of ENO2 gene in peripheral blood of children with autism spectrum disorder (ASD),in order to provide theoretical evidence for early screening of ASD. Method Peripheral blood from ASD children and control children were collected to analyze differential methylation by methylated-DNA immunoprecipitation (MeDIP) chips. One neuron-specific gene,ENO2,was found to be hypermethylated in the autistic samples. In addition,obtained blood samples were collected from 101 autistic children and controls matched with age and sex. This difference was validated by bisulfite sequencing PCR (BSP). The differential expression of ENO2 gene was further analyzed by real-time quantitative polymerase chain reaction (RT-qPCR) and ELISA. Results The hypermethylation of ENO2 within the promoter region was confirmed by BSP to be present in 15.8% (16/101) of the autistic samples. The methylation frequency of 16 CpG sites of ENO2 gene promoter was calculated,and it was found that the closer the promoter was to the start site of transcription,the higher the methylation frequency would be. The mean level of ENO2 RNA in these 16 autistic samples was reduced by 30% approximately compared with that in controls. The average level of ENO2 protein expression in 16 autistic samples was (15.15±3.52) μg/L,about half of that in the controls[ (33.78±8.18) μg/L]. Conclusions Hypermethylation of ENO2 gene is found in peripheral blood of 15.8% of ASD children. Moreover,reduced level of ENO2 expression may be a biomarker for a subset of autistic children.

Study on leptin improving anxiety-like behavior induced by chronic stress in adolescent mice

DUAN Peng, CHEN Li, HU Hao, GOU Wei, LIU Li, LEI Xiao-mei

2020, 28(9):  989-992.  DOI: 10.11852/zgetbjzz2020-0968

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Objective To explore the effect of leptin treatment on anxiety-like behavior caused by chronic restraint stress in adolescent mice,in order to provide data for the treatment of adolescent emotional disorders. Methods Totally 50 mice aged 21-30 days were subjected to low-intensity (2 h) / high-intensity (4 h) restraint stress for 10 consecutive days.Anxiety-like behavior was observed by elevated plus maze (EPM) and open field test (OFT).Serum leptin level was measured by enzyme-linked immunosorbent assay. Results Serum leptin level in the high-intensity restraint stress (HCRS) group[(4.2±1.3) pg/ml]was lower than that in the control group[(10.4±2.9)pg/ml,P<0.05].In the EPM experiment,the open arm times and the open arm entries in the HCRS group were (68.5±18.9)s and 1.7±1.1,respectively,significantly less than those in the normal group[(101.3±19.8) s,3.8±1.8,P<0.01).After the treatment of leptin,the above two indexes increased to (93.8±16.4)s and 3.3±1.6,respectively,which were close to the normal level.In the OFT experiment,the time spent in central area of HCRS mice[(63.4±15.9)s]was lower than that of the control group[(142.5±20.2) s,P<0.01],and this index was prolonged to (130.5±26.5)s after the application of leptin.However,there was no significant change in the indexes of the adolescent mice experienced low-intensity restraint stress in the two experiments. Conclusion HCRS can cause the anxiety disorder of adolescentmice,and using chronic leptin increases serum leptin levels and improve anxiety symptom.

Nurturing care framework and strategy

WANG Jing, TONG Mei-ling

2020, 28(9):  993-996.  DOI: 10.11852/zgetbjzz2020-0489

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Early childhood development has a long-term influence on an individual′s physical development,brain development,mental health,and even has an impact on the health and wellbeing whose benefits last a lifetime and carry into the next generation.But a significant number of children are still at risk of stunting,whose development is the key to the well being of all mankind.The implementation of nurturing care can effectively improve the early development potential of babies,ensure children′s good health and nutrition,and protect them from threats.Nurturing care also means giving young children opportunities for early learning,through interactions that are responsive and emotionally supportive.This review systematically introduces the nurturing care framework and strategy,thereby providing a basis for further clinical and scientific research.

Research progress on the childcare quality and child development

HUANG Ying, ZHANG Hai-feng, TONG Lian

2020, 28(9):  997-1000.  DOI: 10.11852/zgetbjzz2020-0444

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China has started the early childhood care and education (ECCE) services for children under three years old officially since 2019.Understanding the impact of ECCE on children′s health and development is important.Existing studies have showed the short- and long-term effect of ECCE quality on children′s development.This paper reviews the primary studies conducted in developed countries on this theme.A consistent research conclusion is drawn that high-quality ECCE can promote the cognitive and non-cognitive development of children,and the benefits could continue into adulthood,laying a good foundation to for the lifelong development of people.Higher quality of ECCE is beneficial to children′s physical and mental health,which induces more social and economic benefits.This review suggests that it is necessary to carry out childcare cohort study to clarify the short- and long-term of ECCE on child development in China.From the practical aspect,it indicates that the quality assessment for ECCE services is the first step to improve the entire quality of ECCE.

Research progressof the influence of mother-infant interaction on infants and schizophrenia mothers

DING Hui, LIU Ying-ying, CHEN Li, YANG Min

2020, 28(9):  1001-1004.  DOI: 10.11852/zgetbjzz2019-1988

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Mother-infant interaction is one of the most important social activities in early childhood life,which has been a growing concern of researchers nowadays.The mother-infant interaction for patients with schizophrenia refers to the interaction between the mothers with schizophrenia and her baby.Unlike the traditional concept of mandatory mother-infant separation,mother-infant interaction can not only avoid the mother-child separation,but also reduce the mothers emotional stress and improve their self-efficacy.Compared with normal people,there are some problems between mothers with schizophrenia and their infants,such as low sensitivity and responsiveness,less engagement,more serious interaction and so on.Based on this,it is necessary to systematically explain the mother-infant interaction of patients with schizophrenia,understand the current research situation to improve the public and researchers′ attention,thereby providing reference for the relevant research in China.

Research progress onscreen time and health among children and adolescents

WU Yue, QU Wei-li, ZHUANG Xuan, TANG Ji-wen, WANG Yu-xi, WEI Li-li

2020, 28(9):  1005-1008.  DOI: 10.11852/zgetbjzz2019-1477

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With the increasing screen time of children and adolescents,researches on screen time are also increasing.This review mainly summarizes the influence of screen time on poor behavior habits,physical health and mental health among children and adolescents,so as to provide a reference for further researches on the screen time effecting health among children and adolescents.

Review on the mechanism and treatment strategies of comorbidities related to tic disorder

KE Zhong-ling, CHEN Yan-hui

2020, 28(9):  1009-1012.  DOI: 10.11852/zgetbjzz2019-1413

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Tic disorder is a kind of neurodevelopmental disorder which starts in childhood and mainly presents as tic symptoms.Its clinical manifestations are diverse and can be accompanied by a variety of comorbidities.Comorbidities increase the complexity and severity of disease,affect the healthy development of children′s learning,social adaptability,personality and psychological quality,and cause many difficulties in treatment.At present,the mechanism of tic disorder comorbidity is not clear,and the treatment strategy is controversial.This paper aims to review the research on comorbidity mechanism and treatment strategy of tic disorder in recent years,so as to improve clinicians′ understanding of comorbidity related to tic disorder.

Investigation on the sleep quality of preschool children born preterm in Shanghai

ZHU Qing-qing, HUA Jing, YANG Qing

2020, 28(9):  1013-1016.  DOI: 10.11852/zgetbjzz2019-1653

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Objective To investigate the sleep quality of preschool children who were born preterm in Shanghai,in order to provide reference for improving the sleep quality of premature infants. Methods A total of 8 586 children from 20 kindergartens were selected from May to June 2018 by a random cluster sampling survey,of whom 848 were preterm infants.A questionnaire was applied to investigate basic information about preterm children and their families,sleep habits and sleep disorders about children. Results The incidence of sleep problems was 96.9%,and serious sleep problems rate was 45.9% in 848 preschool children who were born preterm in Shanghai.The most common sleep problems included fear of going to bed (74.3%),snoring (64.9%) and difficulty in falling asleep (56.6%).The incidence of bruxism in boys(54.7%) was significantly higher than that in girls(41.4%)(χ²=14.717,P＜0.001).The average length of sleep was (1.59±0.66) hours in the daytime,(9.19±0.92)hours in the night,and(10.78±1.10)hours in the whole day on average.With the growth of the age,there was a significant decrease in the sleeping time of daytime and whole day(F=15.573,8.086,P＜0.001).With the increase of age,the incidence of night terrors(F=18.745,P＜0.001) and daytime sleepiness(F=1.044,P=0.791)decreased,while the incidence of growth pain increased(F=4.134,P=0.227).The detection rate of sleep insufficiency in preschool children who were born preterm in Shanghai was 16.3%,which gradually increased with age. Conclusions Sleep problems,comorbidity of multiple sleep problems,and sleep insufficiency are prevalent in preschool children who were born preterm in Shanghai.Therefore,the sleep quality of preschool children born preterm in Shanghai can not be ignored,and should be given more concern.

Analysis of the status quo and influencing factors of early warning screening of psychological behavior in infants aged 24 months

SHI Qian-ping, HUANG Ai-qun, PAN Xiao-ping

2020, 28(9):  1017-1020.  DOI: 10.11852/zgetbjzz2019-1706

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Objective To know about the screening situation of early warning signs of psychological behavior in infants aged 24 months,and to explore the possible influencing factors,so as to provide reference for the effective screening in clinic. Methods A total of 2 731 infants born in 2016 were selected by random sampling in 5 counties across the 4 provinces in China,and the basic information of maternal and infants,feeding conditions,growth and health conditions were collected by follow-up survey.The national early warning sign screening table was used to screen children with mental behavior retardation. Results The positive screening rate of psychological behavior early warning signs in 2-year-old children was 6.65%,and significant differences existed between different gender and region groups(P<0.05).The results of single-factor analysis showed that there were significant differences on the positive rate of psychological behavior early warning signs among children with different breast-feeding duration,family living environment,outdoor activities and interaction time (P<0.05).Logistic regression analysis showed that boys (OR=2.169,95%CI:1.516―3.103),living in northern China (OR=2.308,95%CI:1.630―3.267),breastfeeding less than 6 months (OR=1.645,95%CI:1.088―2.489),and children′s outdoor activities less than 4 hours (OR=2.715,95% CI:1.548―4.761) were risk factors for the positive results of early warning screening in 2-year-old children. Conclusions It is suggested to pay more attention to early psychological behavior screening,early detection,early referral,early intervention in infants.In addition,parents are encouraged to promote breastfeeding,share more time to accompany infants and take part in outdoor activities,thereby facilitating the healthy growth of children.

Correlation between hyperactivity tendency and attentional inhibition function in preschool children with purulent meningitis

BAI Li-yi, WANG Ying, GUO Tian-tian, LI Jun-fa, NI Guo-xin, LUO Yan-lin

2020, 28(9):  1021-1024.  DOI: 10.11852/zgetbjzz2019-1715

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Objective To evaluate the association of attentional inhibition function with their attention deficit hyperactivity disorder (ADHD) behavior scores,so as to provide experimental evidence on the risk of suffering from ADHD in preschool children with purulent meningitis. Methods A total of 53 children aged 3-5 years with purulent meningitis (33 males and 20 females) from Zhengzhou Children′s Hospital and 45 controls (24 males and 21 females) from kindergarten were recruited from September 2017 to May 2018 in present study.Attentional inhibition function was measured by GO/NOGO experiment,while hyperactivity tendency was assessed by the Children′s ADHD Behavior Scale for all subjects.Pearson correlation analysis was used to explore the pairwise correlation between attentional inhibition and ADHD behavior scores. Results In the GO trial and the NOGO trial,the reaction time in purulent meningitis group was longer than that in control group[GO:(2 260.6±654.2) ms vs.(1 105.8±499.4) ms,P<0.01;NOGO:(2 220.2±693.6) ms vs.(1 017.3±454.9) ms,P<0.001].The ADHD behavior score in the purulent meningitis group was higher than that in control group[(13.1±4.1) vs.(10.9±4.6),P<0.001].According to the Pearson correlation analysis,the reaction time of NOGO trail was positively related to ADHD behavior score (r=0.320,P=0.03) in the purulent meningitis group. Conclusion Preschool children with purulent meningitis have obvious deficits in attentional inhibition,which may be related to their hyperactivity behavior.

Analysis of clinical characteristics of functional articulation disorders in children at different age stages

HUANG Li-ping, ZENG Pei-pei, CHEN Ling, XIONG Li, ZENG Ting, DENG Liang-qiong

2020, 28(9):  1024-1027.  DOI: 10.11852/zgetbjzz2020-0596

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Objective To analyze the clinical characteristics of functional articulation disorders in children at different age stages,so as to provide evidence and reference for intervention and treatment. Methods Totally 153 children were enrolled in this study and were divided into 4-year-old group,5-year-old group and 6- to 9-year-old group.Specific tests and treatment were carried out to analyze the error patterns and curative effect. Results The average numbers of consonant errors in 4-year-old group,5-year-old group and 6- to 9-year-old group were 9.3,7.8 and 6.5 units,respectively.The highest error rate was palatal consonant,about 90.8%.The commonest errors were pronouncing as retroflex and dental consonant,with error rates about 74.5% and 46.4%,respectively.The error rates of substitution,distortion and omission were 98.0%,62.7% and 7.2%,respectively.The degree of disorder,the pronunciation errors of labial,labiodental,retroflex,velar,and dental consonants,as well as the errors of pronouncing as inalveolar,plosive,affricate,unaspirated consonants and omission were significantly different among different age groups (P<0.05). Conclusions Age has an influence on the degree of articulation disorder.With the increasing of age,the pronunciation of most consonants improved,but most of the error patterns and curative effect are not affected.When developing the problem of functional articulation disorders,children should be treated as soon as possible regardless of age.

Analysis on the current situation and influencing factors for health services utilization of disabled children in Guangzhou

LONG Ying, LIU Ke, WANG Yun

2020, 28(9):  1028-1032.  DOI: 10.11852/zgetbjzz2019-1947

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Objective To investigate the current situation and influencing factors of health service utilization among disabled children in Guangzhou,in order to provide evidence for improving the utilization of health services for disabled children. Method A questionnaire survey was conducted on parents of disabled children in Guangzhou Rehabilitation Center and 4 special schools by using the self-designed questionnaire for Health Services of Disabled Children. Results Totally 511 valid questionnaires were returned. 1) The two-week consultation rate of disabled children was 25.2%,and the influencing factors included children′s age,study style and the health status of children′s parents and accept minimum living allowance(P<0.05). 2) The annual hospitalization rate of disabled children was 17.2%,and the influencing factors included children′s age and disability grade,parents′ understanding of early intervention (P<0.05). 3) Vaccination rate of disabled children was 61.1%,and regular physical examination rate was 21.5%. The factors influencing regular physical examination rate were study style and accept minimum living allowance (P<0.05). 4) The rehabilitation training rate for disabled children was 58.9%,and the influencing factors included children′s age,types of disability,being an only child,study style and parents′ understanding of early intervention (P<0.05). And the rate of regular follow-up was 19.2%. Conclusions The accessibility and initiative awareness of health services are insufficient,and the utilization of health services among disabled children is suggested to be improved. A reasonable and effective social security system of health services should be established to optimize the accessibility of health resources,strengthen the health education of prevention and early intervention of disabled children,improve the initiative of parents to use services,thereby promoting the healthy growth of disabled children.

Investigation on the mental health of preschool children and the relevant factors during coronavirus disease 2019

LIANG Jing, WANG Zhao-hui, LI Yan-hui, LI Hong-juan, QI Jing, HE Xi, BAI Rui-bei

2020, 28(9):  1033-1036.  DOI: 10.11852/zgetbjzz2020-0369

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Objective To investigate the influence of coronavirus disease 2019(CoV-19)on children′s mental health,so as to provide basis for children′s psychological intervention under the emergency of major public health events. Methods A total of 20 579 children from 32 provinces and autonomous regions were randomly selected from February 12th to 20th,2020 via online questionnaire.Parents filled out self-made questionnaire on mental health status of children in the epidemic period of CoV-19.The general data were described and analyzed.Kruskal-Wallis H test,Spearman correlation analysis and multiple linear regression method were used to analyze the influencing factors of children′s mental health. Results 1)Among 20 579 children,73.70% had increasing parent-child interaction time,69.85% had increasing family density,63.63% used more electronic screens,37.39% had irregular work and rest,31.26% had excessive activities,and 20.37% had abnormal sleep.2) Significant difference on children′s behavior scale was found among children with different residential areas (H=80.891,P<0.001).3)There were statistically significant differences between parents of only children and non-only children in terms of emotion,family intimacy and epidemic pressure (H=14.824,10.914,18.254,P<0.01).Parents of children living in different places had significant differences on emotional,cognitive,family intimacy,epidemic pressure(H=68.398,50.240,56.027,54.250,P<0.001).4) Parents′ cognitive,emotion,epidemic pressure were negatively correlated with children′s behavior,family intimacy were positively related to children′s behavior (P<0.001),which all entered the regression equation (F=733.447,P<0.001,△R²=0.125) explaining 12.5% of the children′s behavior. Conclusions Children′s abnormal behavior during the epidemic of CoV-19 is mainly manifested in the prolonged electronic screen time,irregular work and rest,excessive activities and sleep problems.More attention should be given to preschool children in cities and towns during the epidemic period.Moreover,family environment is an important factor to maintain good psychological state of children during the epidemic.

Analysis on the needs of early childhood care and education for children under 3 years old in Xuhui district of Shanghai

ZHANG Hai-feng, WANG Ke-li, HUANG Ying, TONG Lian

2020, 28(9):  1037-1040.  DOI: 10.11852/zgetbjzz2020-0037

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Objective To investigate the current needs for early childhood care and education Xuhui district,Shanghai,and to clarify the relative factors,in order to provide suggestion for the valid supply of early childhood care and education service. Methods A total of 1 869 parents for children under 3 years old were recruited in 13 streets of Xuhui district in Shanghai in June 2019 by multi-stage sampling method,and were asked to fill out the questionnaire online. Results Totally 51.4% families were willing to send their children to the childcare institutions,Among them,44.4% of parents expected their children to be enrolled at the age of 1 to 2 years old,and 45.9% expected their children to be enrolled at the age of 2 to 3 years old. Moreover,52.3% parents would like to use early childcare services in nursery classes of kindergartens,while 93.7% parents preferred the institution that provided meals during the care period. In terms of the admission fee,the maximum affordable fee for childcare services was 2 000-4 999 yuan per months for 60.9% families. The higher the maximum monthly cost a family can afford,the more likely they were to utilize childcare institutions (OR=1.47,95%CI:1.22-1.78). Mothers who have a nine-to-five job were 4.20 times more likely to use childcare institutions than those who do not work (OR=4.20,95%CI:2.92-6.06). Conclusions Increasing the community-based early childhood care and inclusive childcare will enhance the accessibility and availability of child-care services supply. Moreover,the needs of working mother should be taken into consideration.

Study on the correlation between the level of asthma control and sleep disturbance in asthmatic children

LI Zhen-zhen, LI Shi-yi, HAN Chun-fang, YU Li-ping, SHEN Qiu-yan, GUAN Yun, CHEN Ou

2020, 28(9):  1040-1043.  DOI: 10.11852/zgetbjzz2020-0629

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Objective To understand the level of asthma controland the correlation between asthma control level and sleep disturbance in asthmatic children,so as to provide evidence for the prevention of sleep disturbance in asthmatic children. Methods Totally 200 children with asthma aged 6—11 years and their parents were surveyed with general information survey,Childhood Asthma Control Questionnaire(C-ACT),Sleep Disturbance Scale for Children (SDSC) in Weifang People′s Hospital from October 2018 to October 2019. According to C-ACT score,children were divided into three group:complete control group (≥23,n=75),partly control group (20-22, n=46) and uncontrolled group (≤19,n=79). Sleep disturbance of the three groups were compared,and the correlation between SDSC score and score of C-ACT was analyzed. Results The complete control rate in children with asthma was 37.5%,the partly control rate was 23.0%,and the uncontrolled rate was 39.5%. The total score of SDSC scale in complete control group,partly control group and uncontrolled group were 34.21±3.60,38.74±2.86,and 40.09±5.37,respectively. Moreover,the detection rates of sleep disturbance in complete control group,partly control group and uncontrolled group were 49.4%,40.0%,and 20.0%,respectively,there was significant difference on the detection rates of sleep disturbance(χ²＝15.224,P<0.001). And the total score of C-ACT was negatively correlated with SDSC score(r=-0.623,P<0.01). Conclusions The level of asthma control with asthmatic children is poor in this area,and the detection rate of sleep disturbance in children with asthma is higher. The sleep quality of children with asthma completely controlled is significantly better than that of children with asthma partly controlled and uncontrolled. Pediatric medical staff should pay more attention to the asthma control during the treatment of asthma,and improve sleep quality through good asthma control,thereby promoting the growth and development of children.

Association between sleep duration and hypertension among children aged 7 to 17 years in Liuzhou

HUANG Ting, ZHOU Zhou, WEI Lin, XIAO Li-na, ZENG Ting, LIU Qing

2020, 28(9):  1044-1046.  DOI: 10.11852/zgetbjzz2019-1430

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Objective To investigate the prevalence of hypertension and inadequate sleep among primary and secondary school students in urban areas in Liuzhou,and to explore the relationship between sleep duration and blood pressure in children and adolescents. Methods A total of 2 354 children aged 7 to 17 years were selected as participants by stratified cluster sampling in Liuzhou city.The blood pressure,height and weight of children were measured.Sleep duration and related information were determined via questionnaires. Results The prevalence rate of hypertension was 19.83% (21.68% for boys and 18.17% for girls).The median sleep duration was (7.85±1.14) hours and sleep insufficiency rate was 74.21%.A short sleep duration was associated with higher SBP and DBP (β=-0.101,-1.097)and sleep insufficiency was associated with a higher risk of hypertension when compared with the sufficient-sleeping group among boys (OR=1.93,95%CI:1.24-3.01,P=0.004). Conclusion The prevalence of hypertension and insufficient sleep rate among primary and middle school students in Liuzhou are at a high level,and the association between sleep duration and hypertension has an opposite gender difference.

Study on the comparison of early developmental screening tools and related clinical significance among children with autism

ZHANG Yue, LI Yun, HUANG Jun, ZHANG Ying, YAO Yi

2020, 28(9):  1047-1050.  DOI: 10.11852/zgetbjzz2019-1721

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Objective To evaluate the application of screening tools for autism spectrum disorder (ASD) in children in the primary child healthcare service,so as to provide advisable information for selecting appropriate tools. Methods A total of 2 639 children received physical examination in Minhang Maternal and Child Health Care Center from 2013 to 2018 were selected in this study,of whom 2 525 were conducted CHAT-23 screening test and 1 979 received Developmental Screening Test for Child under six(DST).Both screening tests above and autism diagnosed results were collected from Minhang electronic health record retrospectively,so as to compare the predictive value of single screening test alone with joint screening test. Results Finally 34 children were diagnosed with ASD among 2 639 children.And the sensitivity CHAT-23 for screening ASD was 0.265.Compared with CHAT-23 screening ASD alone,CHAT-23 combined with DST suspicious results of DST together could higher the sensitivity (0.906 vs.0.265) and Youden index (0.481 vs.0.261),which is of great significance for avoid missed diagnosis. Conclusion Considering the high accuracy of both CHAT-23 results filled out by parents and DST results conducted by physicians,this method will improve the of screening child autism and help early detection,diagnosis and intervention of child autism,and is worthy being used in primary child health care service.

Weight control behaviors and their association with real and perceived weight status among 1 026 first year high school students in Lanzhou

FAN Zhi-tao, YU Xin-yang, YU Chao-ran, LIANG Rui, WANG Kui

2020, 28(9):  1051-1054.  DOI: 10.11852/zgetbjzz2019-1708

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Objective To examine the weight control behaviors among the first grade high school students in Lanzhou,and to further examine their association with real and perceived weight status,in order to provide reference for scientific prevention and intervention. Methods In September 2018,1 038 first year high school students filled in the Weight Control Behavior Scale for Youth and Adolescents and answered questions regarding their perceptual weight status. Finally 1 026 valid response were collected.Total scores and adoption rates of healthy and unhealthy weight control behaviors were calculated. Results Among 1 026 high school students,364(76.15%) girls and 387(70.63%) boys adopted weight control behaviors. The most frequently adopted healthy weight control behaviors were "doing exercise" [boys 416(75.91%),girls 318(66.53%)] and "eating more fruits and vegetables" [boys 412(75.18%),girls 395(83.51%)]. While the two most frequently adopted unhealthy weight control behaviors were "skipping meals" [boys 93(16.97%),girls 82 (17.15%)] and "eating no meat"[boys 37(6.75%),girls 79(16.53%)]. More boys (21.63%) were actually overweight than girls (9.79%). However,52.83% of girls perceived overweight. Moreover,students who perceived overweight were more likely to adopted unhealthy weight control behaviors (χ²=38.94,P<0.01). Conclusions Weight control behaviors are common among first year high school students,which are associated with their weight perceptual bias. Therefore,psychological prevention and interventions are needed.

Clinical study on training strategies of ability of daily living activities for childrenwith cerebral palsy based on real life orientation

FAN Tao-lin, LUO Sha, XIAO Ting, YANG Yan-wen

2020, 28(9):  1055-1059.  DOI: 10.11852/zgetbjzz2020-0644

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Objective To explore effective strategies for ability of daily living activities (ADL) training of cerebral palsy (CP) children based on real-life orientation by implementing a combination of medical and teaching methods. Methods A total of 41 children with CP who were treated in Xiangya Boai Rehabilitation Hospital from April 2017 to August 2018 were enrolled in this study and were randomly divided into control group and study group.The control group was given conventional ADL training,and study group received real-life-oriented ADL training,orientated by personal hygiene or self-care,community transfer-functional movement,hand function operation,daily life communication and social activities,respectively.Before and after treatment,Children′s Living Function Assessment Scale (PEDI),Children′s Functional Independence Rating Scale (WeeFIM),and the Chinese Version of the Children′s Quality of Life Cerebral Palsy Scale (PedsQL^TM) 3.0 were used to assess children′s ADL skills,functional independence and quality of life(QOL). Result After 4 months of treatment,the PEDI,WeeFIM and PedsQL^TM 3.0 scores of the two groups were significantly higher than those before treatment (control group:t=14.796,6.954,31.104;study group:t=5.613,31.576,20.193,P＜0.01),and the scores of study group were significantly better than those of the control group (t=2.247,2.233,2.119,P＜0.05). Conclusion Accepting the idea of combining medicine with education and whole-person development,and selecting individualized training strategies in ADL training,especially ADL training models based on real life orientation,can effectively improve ADL skills and QOL in CP children,thereby advancing children′s ability to live independently in real life.

Expert consensus on nurturing care for infants and toddlers

Infants Nurturing Care Professional Council, Chinese Maternal and Child Health Association

2020, 28(9):  1063-1068.  DOI: 10.11852/zgetbjzz2020-1357

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