Table of Content

10 November 2020, Volume 28 Issue 11

Previous Issue    Next Issue

Outcome and rehabilitation of neonatal brain injury

JIA Fei-yong

2020, 28(11):  1185-1187.  DOI: 10.11852/zgetbjzz2020-1805

Asbtract ( )   PDF (504KB) ( )  

References | Related Articles | Metrics

Neonatal brain injury (NBI) is a disease with diverse etiology and symptoms, resulting in abnormal development of children.The outcome and rehabilitation of neonatal brain injury have raised much attention from medical professionals in recent years.And the recent progress in this field is reviewed in this paper.

Study on the connectivity between primary auditory brain regions and whole brain and its association with sensory behavior in autism spectrum disorder boys

WANG Xiao-min, WANG Jia, ZHAI Jin-he, FU Kuang, WU Qiong, LI Yu-tong, YU Shuo, WU Li-jie

2020, 28(11):  1188-1192.  DOI: 10.11852/zgetbjzz2019-0422

Asbtract ( )   PDF (785KB) ( )  

References | Related Articles | Metrics

Objective To analyze the functional connectivity characteristics between primary auditory brain regions and whole brain in resting state in children with autism spectrum disorder (ASD),and to explore the correlation with sensory behaviors. Methods The fMRI data of 34 ASD boys and 29 healthy boys were collected.And BA41/42,which was related to primary auditory,was used as the seed region to generate intrinsic functional connectivity maps based on resting-state functional connectivity magnetic resonance imaging (rs-fcMRI) to identify brain regions with altered connectivity.Short Sensory Profile (SSP) was used to assess the sensory behaviors of ASD children.Correlation between the altered functional connectivity and sensory behaviors in ASD children was examined by Pearson analysis. Results ASD group had decreased functional connectivity between BA41/42 and left posterior cingulate gyri,and it was negatively correlated with tactile sensitivity,taste/olfactory sensitivity and total scale scores in the SSP scale (r=-0.496,-0.420,-0.415,P<0.05).ASD group had increased functional connectivity between BA41/42 and left median cingulate and paracingulate gyri,and there was a negative correlation with tactile sensitivity,low response/seeking stimulus,auditory filtering,and total score of the SSP scale(r=-0.650,-0.499,-0.447,-0.541,P＜0.05),and a positive correlation with SSP level,including tactile sensitivity,taste/olfactory sensitivity,motor sensitivity,low response/seeking stimulation,low strength/weakness,and total scale score (r=0.423,0.527,0.467,0.471,0.470,0.642,P＜0.05).And ASD group had increased functional connectivity between BA41/42 and left supplementary motor area. Conclusion ASD children have abnormal functional connectivity characteristics between primary auditory brain regions and whole brain in resting state,providing an objective evidence of brain functional connectivity for abnormal sensory behaviors.

Effects of exposure to lead, manganese and cadmium on growth and neurocognitive function in children

WANG Xin-yue, LI Jian-wei, MENG Xiao-jing, LI Xian, LIU Fen

2020, 28(11):  1193-1196.  DOI: 10.11852/zgetbjzz2020-0514

Asbtract ( )   PDF (525KB) ( )  

References | Related Articles | Metrics

Objective To investigate the effects of exposure to heavy metals such as lead, manganese and cadmium on children's growth, development and neurocognitive function. Methods Totally 243 children who underwent preschool physical examination in Shilong Town Hospital in Dongguan City from September 2017 to September 2019 were enrolled in this study.The content of blood lead, manganese and cadmium was measured, and then children were divided into high-lead (n=31) and low-lead group (n=212), high-manganese (n=46) and low-manganese group (n=197), high-cadmium (n=50) and low-cadmium group (n=193).Correlations of the three heavy metals levels with children's age, height, weight, spatial memory ability, target tracking attention, spatial rotation ability were analyzed to explore the impact of blood lead, manganese and cadmium on neurocognitive function of children. Results The height of children in high-lead group was lower than that in low-lead group.Blood lead level was negatively correlated with children's height, spatial memory ability, target tracking attention and spatial rotation ability (r=-0.180, -0.367, -0.334, -0.217, P＜0.05).Blood cadmium level was negatively related to spatial memory capacity (r=-0.140, P＜0.05).Blood manganese had no significant correlation with age, height, weight, spatial memory ability, target tracking attention and spatial rotation ability (P＞0.05). Conclusions The increase of blood lead level may affect the growth and development of children in this area.In addition, the increase of lead and cadmium may impact the neurocognitive function, especially the decrease of memory ability.It is necessary to detect heavy metal pollution as early as possible and intervene in time to ensure children's physical and mental health.

Effect of multi-sensory stimulation therapy on the motor function of infants with global developmental delay

CHEN Mei-hui, LI Xiao-jie, TANG Jing-hua, XU Lei, FENG Shu, LIU Yu-jiao

2020, 28(11):  1197-1200.  DOI: 10.11852/zgetbjzz2020-0102

Asbtract ( )   PDF (1158KB) ( )  

References | Related Articles | Metrics

Objective To analyze the efficacy of multi-sensory stimulation therapy on infants with global developmental delay (GDD) and young children's motor function, so as to provide clinical practice experience and evidence-based evidence for promoting the development and comprehensive development of GDD infants' motor function. Methods A total of 40 GDD children, aged 0—2 years and diagnosed with GDD in the Third Affiliated Hospital of Jiamusi University, were enrolled in this study.Then the participants were divided into the control group (n=20) and the experimental group (n=20) according to the random number table method.The control group received conventional rehabilitation, while the experimental group was given 8-week one-to-one sensory stimulation therapy for 30 minutes per day, 5 days per week, additionally.The gross motor development quotient (GMQ), fine motor developmental quotient (FMQ) and total developmental quotient (TMQ) of participants were evaluated using the Peabody Sports Development Scale before treatment, and 4 and 8 weeks after treatment. Results GMQ, FMQ, TMQ scores of the experimental group and the control group were significantly improved after 4 weeks and 8 weeks of treatment compared with those before treatment (P<0.001).After 8 weeks of treatment, the GMQ, FMQ and TMQ scores of the experimental group and the control group were significantly higher than those of the same group after 4 weeks of treatment(t=-9.354, -7.997, -14.518, -10.162, -6.102, -14.313, P＜0.001).The GMQ, FMQ and TMQ of the experimental group after 4 weeks and 8 weeks of treatment were distinctly higher than those of the control group(t=-2.322, -2.306, -2.276, -3.396, -3.392, -3.664, P＜0.05). Conclusion Multi-sensory stimulation therapy is beneficial to improving the motor function of infants with GDD.

Comparative analysis of sleep patterns in 3- to 6-year-old preterm and full term children in Shanghai

ZHU Qing-qing, HUA Jing, YANG Qing

2020, 28(11):  1201-1204.  DOI: 10.11852/zgetbjzz2019-1798

Asbtract ( )   PDF (491KB) ( )  

References | Related Articles | Metrics

Objective To comparative analyze sleep patterns in 3-to 6-year-old preterm and full term children in Shanghai,in order to provide reference for further exploring the effect of preterm on sleep patterns. Methods Totally 8 586 children from 20 kindergartens in Shanghai were selected by a random cluster sampling survey from May to June 2018,of whom 848 were preterm infants.Children's parents were investigated by a self-designed questionnaire to collect basic information about children and their family and sleep habits. Results Preterm children woke up earlier than full term children[(6:58±0:28) vs.(7:06±0:27), t=-2.675,P＜0.05].And the nighttime sleep time[(9.19 ± 0.92) h] and the daily total sleep time[(10.78 ± 1.11) h] of preterm children were significantly less than those of full term children[(9.29±0.77) h,(10.88±0.99)h,t=-3.191,-2.363,P＜0.05].The prevalence of sleep deficiency in preterm children was significantly higher than that in full term children (16.3% vs.11.7%,χ²=14.624,P＜0.001).And the prevalence of sleep deficiency increased with age in preterm children and full term children (χ²=20.024,207.074,P＜0.001).Sleep deficiency in children was associated with their age,premature birth,parents' profession,per-capita disposable income and marital status. Conclusions The sleep pattern in 3- to 6-year-old preterm children is less mature than that of full term children in Shanghai,and improvement and fixed of sleep pattern are delayed,suggesting that the maturity of nervous system in preterm children is worse than that in full term children.Thus more attention should be paid to sleep guidance and intervention in follow-up of preterm children.

Analysis of motor assessment in children with autism spectrum disorders

XIONG Cai-yun, YANG Yuan-yuan, LI Jia-qiong, WANG Yao-zhou, LUO Lin-yin, YANG Zai-lan, JIANG Lu, ZHOU Hao

2020, 28(11):  1205-1208.  DOI: 10.11852/zgetbjzz2020-0511

Asbtract ( )   PDF (565KB) ( )  

References | Related Articles | Metrics

Objective To investigate the motor function development in children with autism spectrum disorders (ASD), so as to provide clinical evidence for precise intervention for ASD children. Methods A total of 182 ASD children at developmental-behavioral pediatrics of Guizhou Provincial People's Hospital from March, 2017 to December, 2019 were included in this study.And their assessment results of motor function development were retrospectively analyzed. Results The motor function assessment revealed that the mean score of gross motor (GM) and fine motor (FM) and total motor (TM) was 69.9±13.7, 75.2±15.5, and 70.1±13.8, respectively. The rate of GM, FM and TM delays was 78.0%, 61.5% and 75.8%, respectively. There were significant positive correlations between motor function and intelligence in autism(r ranged from 0.018 to 0.672), the subscales of FM was the most highly correlated with intelligence. In addition, the grasping motor of FM in girls with ASD was superior to that in boys, and the grasping motor obviously lagging behind of children with ASD more than 3 years old. Conclusions ASD children have distinct motor development delays.Early assessment of motor function is urgently needed in ASD children to help make personalized intervention in clinical practice.

Study on the efficacy of low frequency computerized executive function training in children with attention deficit hyperacivity disorder

SONG Rui, JIANG Wen-qing, FAN Ning, WANG Zuo-wei, DU Ya-song

2020, 28(11):  1209-1213.  DOI: 10.11852/zgetbjzz2020-0166

Asbtract ( )   PDF (691KB) ( )  

References | Related Articles | Metrics

Objective To evaluate the feasibility of low-frequency computerized executive function training for attention deficit hyperacivity disorder (ADHD) children. Methods Totaly 44 ADHD children aged 6-12 years who met the DSM-5 diagnostic criteria were selected from the outpatient clinic from October 2017 to May 2018,and were divided into the training group and the drug group according to their parents' wishes.The improvement of symptoms and executive function before and after treatment,as well as the acceptance degree of the treatment plan,were taken as the feasibility analysis indicators.Children's symptoms were assessed by SNAP-Ⅳ scale.The executive functions of ADHD children were assessed by digit span test and coding tests of Stroop color-word test,WISC-Ⅳ, Wisconsin Card Sorting Test (WCST). Results The ADHD symptoms of the children improved after the low-frequency executive function training,and the scores of SNAP-Ⅳ subscale of oppositions,attention deficit and hyperactivity were different significantly(t=3.386,2.976,Z＝-2.026,P<0.05 or＜0.01).Some indicators of executive function were improved,including the correct number of Stoop test A,the wrong number of test B,and the time of test B(t/Z=-2.727,2.368,-2.987,P<0.05 or＜0.01).WCST persistent error number and conceptualization level were significantly different after training (t=2.375,-2.614,P<0.05).There were statistically significant differences on the digit span test score and coding test score of WISC-Ⅳ (t=-3.093,-2.723,P<0.05).The children received a higher acceptance of low-frequency training and the drop-out rate was lower.At the end of 8 weeks, the scores of SNAP-Ⅳ oppositions and attention deficit factor in the drug group were decreased,and the difference before and after treatment was highly significant(P<0.01).The correct number in Stroop test B was increased while the time in Stroop test B were decreased,and the difference was statistically significant(t=-4.833,3.360,P<0.01)。 Conclusions Low-frequency computerized executive function training is effective and feasible that can improve the symptoms and partial executive function of ADHD children.Moreover,children's acceptance for computerized executive function training is high,so it can be widely promoted in clinical practice.

Vitamin D status among 0-5 years old children in Jiangsu province of China

ZHAO Yan, QIN Rui, MA Xiang-hua

2020, 28(11):  1214-1218.  DOI: 10.11852/zgetbjzz2020-0113

Asbtract ( )   PDF (637KB) ( )  

References | Related Articles | Metrics

Objective To explore vitamin D status of 0-to 5-year-old children in Jiangsu province,and to analyze the association between age,sex,birth conditions,region of residence,season,location in Jiangsu province and vitamin D. Methods This was the first large population-based multicenter study in which the representative children aged 0-5 years were recruited from 10 cities by a stratified cluster random-sampling method in Jiangsu Province from April 2014 to March 2015.A face to face investigation was conducted by the prepared doctors with the structured questionnaire to collect related details and serum 25-hydroxyvitamin D[25-(OH)D]concentration was tested by ELISA. Results A total of 5 289 children were investigated.The prevalence rates of vitamin D deficiency and vitamin D insufficiency in 0- to 5-year-old children were 30.1% and 35.5%,respectively.The prevalence rates of vitamin D deficiency in children aged 0- month,12- months,24- months,36- months,48- months and 60-<72 months were 23.0%,21.3%,27.8%,32.4%,37.9% and 39.7%,respectively.And the prevalence rates of vitamin D insufficiency in those children were 26.9%,34.4%,36.5%,38.6%,39.6% and 38.4%,respectively.The level of 25-(OH)D was 64.0 (46.3~83.0) nmol/ml.And the prevalence of vitamin D deficiency in girls (32.1%) was significantly higher than that in boys (28.3%) (Z=8.709,P=0.003).The level of 25(OH)D in girls (62.7 nmol/ml) was significantly lower than that in boys (65.1 nmol/ml) (Z=9.453,P=0.002).Multivariate analysis indicated children with higher risk of vitamin D deficiency were more likely to be children aged 2 to 5 years,girls,the first parity and birth,investigated in Spring and Winter,located in southern,central region and northern of Jiangsu province (P<0.05). Conclusions Vitamin D level of children is generally low in Jiangsu province,especially for preschool children.The vitamin D deficiency and lower 25-(OH)D level are related to age,gender,the number of pregnancy,parity,birth weight,season of survey,region of residence and location in Jiangsu province,but are not associated with gestational age and delivery mode.

Neuroprotective effect of remote ischemic post-conditioning on neonatal hypoxic-ischemic encephalopathy

SONG Lin, GUO Jin, SONG Fu-xiang, ZHANG Peng

2020, 28(11):  1219-1222.  DOI: 10.11852/zgetbjzz2019-1662

Asbtract ( )   PDF (529KB) ( )  

References | Related Articles | Metrics

Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the main causes of neonatal death and disability from all over the world,mainly due to the decrease or complete block of cerebral blood flow during perinatal period.And most newborn survivors have movement disorder and cognitive impairment.As a new treatment for HIE,remote ischemic post-conditioning (RIPostC) has many advantages,such as easy operation,low cost and safe.In addition,it can reduce the infarct area and brain edema,improve nerve cells and regulate various cell pathways to alleviate the nerve injury of HIE.In this paper,the effect of remote ischemic post-conditioning on the morphological signal transduction pathway and prognosis of nerve cells is briefly discussed.

Research progress on the microbiota-gut-brain axis in pathogenesis of neonatal hypoxic ischemic encephalopathy

LI Meng, HE Xue-jia, ZHU Wei-wei

2020, 28(11):  1223-1226.  DOI: 10.11852/zgetbjzz2019-1540

Asbtract ( )   PDF (519KB) ( )  

References | Related Articles | Metrics

Neonatal hypoxic ischemic encephalopathy (HIE) is one of the diseases with high disability rate and mortality rate in the neonatal period.Recent studies have shown that the hypoxic ischemic injury of the newborn brain is related to the oxidative stress of the nervous system and mitochondrial dysfunction of tissue involved in the “microbiota-gut-brain axis”,but its molecular mechanism is still unclear.The most critical link of HIE is the occurrence of secondary energy failure,and the “latency period” between the two energy failure is the so-called “time window” for treatment,which is the best time when the neuroprotective measures to reduce brain injury can be successfully applied.This paper reviews the research progress on “microbiota-gut-brain axis” participating in oxidative stress in the pathogenesis of HIE,thereby providing a new dimension to the interaction between intestinal flora and brain,and opening a door for the prevention and treatment of HIE.

Research advances on docosahexaenoic acid and cognition function deveolpment

WANG Mei-chen, SHI Yu-jie, LIU Biao, REN Zhong-xia, WU Wei, ZHANG Yu-mei

2020, 28(11):  1227-1230.  DOI: 10.11852/zgetbjzz2019-1674

Asbtract ( )   PDF (495KB) ( )  

References | Related Articles | Metrics

Docosahexaenoic acid (DHA) is a long-chain polyunsaturated fatty acid (LCPUFA) that has involved in various functions of life.It plays an important role in brain development,cognitive function and visual development,as well as the immune function of newborns.This article reviews the origins of DHA and its effects on cognitive function,and explores the effects of DHA intake on the development of cognitive function in preterm infants,infants and childhood.However,with the increase of age,there is no significant difference in the influence on the intelligence of school-age children. Appropriate DHA intake of pregnant,lactating mothers and infants is very important for the maintenance of brain DHA level in life cycle.

Research advances on the influence of intestinal flora on neonatal necrotizing enterocolitis

WANG Zhen, YANG Shu-fen

2020, 28(11):  1231-1233.  DOI: 10.11852/zgetbjzz2019-1531

Asbtract ( )   PDF (464KB) ( )  

References | Related Articles | Metrics

Previously,neonatal necrotizing enterocolitis is considered to be related to factors such as preterm birth,hypoxia,artificial feeding,sepsis,intestinal ischemia,and intestinal pathogenic bacteria infection.In recent years,a growing number of studies have shown that intestinal flora disorders also play an important role in the pathogenesis of neonatal necrotizing enterocolitis.This article reviews the effect of intestinal flora on neonatal necrotizing enterocolitis,hoping to provide a reference for the prevention and treatment of neonatal necrotizing enterocolitis.

Meta-analysis of vitamin D and the risk of allergic rhinitis in children

SHE Ning-ning, SHAO Na, XIA Cui, FENG Ya-ni, ZHANG Yi-tong, LIU Hai-qin, REN Xiao-yong

2020, 28(11):  1234-1238.  DOI: 10.11852/zgetbjzz2019-1995

Asbtract ( )   PDF (1723KB) ( )  

References | Related Articles | Metrics

Objective To evaluate the correlation between serum vitamin D(Vit D) level and the risk of allergic rhinitis (AR) in children by Meta-analysis. Methods Case-control studies on the correlation between serum Vit D level and childhood AR published till 15th May in 2019 were searched in computer databases.Literature was selected according to strict inclusion and exclusion criteria and data were cross-extracted to perform Meta-analysis. Results Totally 11 articles involving 3 262 participants were included,of whom 1 718 in AR group and 1 544 in control group.Meta-analysis results indicated that serum Vit D level in AR group were significantly higher than that in control group (SMD=-1.31,95%CI:-1.85--0.77,P<0.001).Vit D₂ level of AR group was significantly lower than that of control group(SMD=-0.17,95%CI:-0.32--0.01,P<0.001).Moreover,Vit D₃ level of AR group was significantly lower than that of control group(SMD=-3.09,95%CI:-3.57--2.61,P<0.001).Subgroup analysis showed the heterogeneity of the experimental results was reduced,which may be influenced by factors such as diet and lighting in different regions. Conclusion Vit D level in children with AR is significantly lower than that in control group,especially Vit D₃,suggesting Vit D₃ deficiency may be an important factor for AR in children.

Clinical application value of lung ultrasound in neonatal respiratory dysfunction

LUO Yan, ZENG Jie, ZHANG Wei-quan, PENG Juan, NIU Jin-dong, LIANG Kun

2020, 28(11):  1239-1241.  DOI: 10.11852/zgetbjzz2019-1683

Asbtract ( )   PDF (624KB) ( )  

References | Related Articles | Metrics

Objective To analyze the diagnostic accuracy rate of lung ultrasound and chest X-ray in neonatal respiratory dysfunction (NRD),as well as the consistency between lung ultrasound score and respiratory score,so as to provide evidence for clinical application of lung ultrasound in NRD. Methods A total of 60 neonates with NRD in NICU of the First Affiliated Hospital of Kunming Medical University were enrolled in this study from August 2018 to January 2019(respiratory dysfunction group),and 30 neonates without respiratory disorder were selected as non-respiratory dysfunction group.All subjects performed lung ultrasound,and pulmonary ultrasound scores.The NRD group underwent chest X-ray examination and received Silverman-Anderson (SA) score and Downes score assesment.All data were analyzed by SPSS 23.0. Results The sensitivity and specificity of the lung ultrasound diagnosis for NRD were 96.7%,the accuracy of lung ultrasound diagnosis was 88.3%,and the accuracy of chest X-ray diagnosis was 83.3%.The two diagnostic methods were moderately consistent(Kappa=0.523,P<0.001).Lung ultrasound score was positively correlated with SA score and Downes score (r_s=0.585,0.533,P<0.001). Conclusions Lung ultrasound and chest X-ray have a good consistency in the diagnosis of NRD.Lung ultrasound has important clinical application value in NRD.

Study on the clinical value of troponin in myocardial damage of neonatal hyperbilirubinemia

BAI Dan, SHI Jing-yi, ZHANG Yong, ZOU Zhi-hui

2020, 28(11):  1242-1245.  DOI: 10.11852/zgetbjzz2019-1608

Asbtract ( )   PDF (523KB) ( )  

References | Related Articles | Metrics

Objective To analyze the clinical value of troponin in myocardial damage of neonatal hyperbilirubinemia,in order to provide scientific basis for the treatment of neonatal hyperbilirubinemia. Methods A total of 94 full-term infants with hyperbilirubinemia admitted to Sichuan Maternal and Child Health Hospital were enrolled in this study from February 2018 to March 2019,and 94 full-term healthy infants were selected as control group.General data of both groups were collected and the levels of total bilirubin (TBIL),indirect bilirubin (IBIL),direct bilirubin (DBIL),and troponin I (cTnⅠ) were tested.According to the TBIL test result,children in observation group were divided into two subgroups of mild hyperbilirubinemia group and severe hyperbilirubinemia group.Meanwhile,children in observation group were divided into hyperbilirubinemia group and the non-hemolytic hyperbilirubinemia group.The serum index levels of each group were compared. Results The levels of TBIL,IBIL and cTnⅠ in mild hyperbilirubinemia group and severe hyperbilirubinemia group were significantly higher than those in the control group(F=1 652.030,2 150.368,1 470.795,P<0.05).The levels of TBIL and IBIL were significantly higher in children with severe hyperbilirubinemia than those in the mild hyperbilirubinemia group(P<0.05),but there was no significant difference on cTnⅠ between mild hyperbilirubinemia group and severe hyperbilirubinemia group (P>0.05).Correlation analysis showed that there was a significant positive correlation between TBIL,IBIL and cTnⅠ before and after treatment in the observation group (r=0.664,0.415,P<0.05).The TBIL,IBIL and cTnⅠ of children with hemolytic hyperbilirubinemia were significantly higher than those of non-hemolytic hyperbilirubinemia (t=6.924,2.029,2.490,P<0.05). Conclusion The level of cTnⅠ in neonatal hyperbilirubinemia will increase abnormally,so cTnⅠ can be an indicator for the diagnosis and prognosis prediction of myocardial damage of hemolytic hyperbilirubinemia.

Effect of prenatal use of dexamethasone on short-term and long-term prognosis of premature infants

WANG Jin, GENG Qi-lei, XU Da-rong, ZHU Xue-ping

2020, 28(11):  1246-1249.  DOI: 10.11852/zgetbjzz2019-1888

Asbtract ( )   PDF (398KB) ( )  

References | Related Articles | Metrics

Objective To investigate effect of prenatal use of dexamethasone on short-term and long-term prognosis of premature infants,so as to provide scientific reference for improving prognosis of preterm infants. Methods A total of 289 premature infants in Yancheng Maternal and Child Health Care Hospital from January to December in 2011 were analyzed retrospectively.All participants were divided into intervention group (n=128) and control group (n=161) according to whether dexamethasone was suitable for prenatal treatment.According to different gestational age (GA),the participants were further divided into three subgroups:GA＜30 weeks,30-33⁺⁶ weeks and ＞34 weeks.General data and follow-up data of the different groups were compared. Results In children with GA under 30 weeks,the incidence of PWMD+DWMD,PVL,PIVH-IVH and social interaction score at the age of 3 and 6 years old in intervention group were significantly lower than those in control group(χ²=4.493,4.493,4.305,t=2.454,5.832,P＜0.05).And the scores of gross motor behavior and fine motor behavior at the age of 1,2,3,6 years old in intervention group were significantly higher than those in control group(t=3.599,4.231,4.626,8.552,9.171,6.742,P＜0.05).In children with GA 30-33⁺⁶ weeks,the incidence of PVL and PIVH-IVH,and social interaction score at the age of 3 and 6 years old in intervention group were significantly lower than those in control group(χ²=4.182,3.852, t=3.431,2.867,P＜0.05).And the scores of gross motor behavior and fine motor behavior at the age of 1,2,3,6 years old in intervention group were significantly higher than those in control group(t=2.346,2.975,6.446,5.392,2.541,4.683,1.871,6.043,P＜0.05).In children with gestational age over 34 weeks,the scores of gross motor behavior and fine motor behavior at the age of 2,3,6 years old in intervention group were significantly higher than those in control group(t=2.236,3.184,6.130,2.569,5.506,5.131,P＜0.05),while the scores of social interaction at the age of 3 and 6 years old were significantly lowerer than those in control group (t=2.473,2.315,P＜0.05). Conclusion Prenatal application of dexamethasone is of certain protective effect on brain injury of premature infants with small gestational age,and has positive effect on long-term motor and behavior development of premature infants.However,its negative effect on long-term personal social behavior of premature infants is supposed to be considered.

Relationship between exposure levels of bisphenol A and the risk of idiopathic precocious puberty in school-age girls

ZHOU Lan-mei, WANG Qiong-jin, JI Cui-fang

2020, 28(11):  1250-1254.  DOI: 10.11852/zgetbjzz2019-1846

Asbtract ( )   PDF (657KB) ( )  

References | Related Articles | Metrics

Objectives To analyze the relationship between exposure to bisphenol A (BPA) and idiopathic central precocious puberty (ICPP) in school-age girls,thus to provide a basis for preventing ICPP in girls. Methods Totally 110 school-age children diagnosed with ICPP in the Affiliated Hospital of Yangzhou University were enrolled in this study from July 2016 and September 2018,meanwhile 110 healthy girls were selected as controls matched with age and body mass index (BMI).Urinary BPA concentrations of all girls were tested and its association with the risk of ICPP was analyzed.Laboratory examinations including serum estradiol (E2) level,basal and gonadotropin-releasing hormone (GnRH) stimulated luteinizing hormone(LH),and follicle-stimulating hormone (FSH) levels,bone age (BA),and uterine and ovarian sizes were conducted in ICPP girls. Results Median concentrations of urinary BPA in ICPP group and control group were 6.25 μg/g Cr and 1.07 μg/g Cr,respectively (Z=-3.845,P＜0.001).After adjustment for confounders,the risk of ICCP in girls with highest concentrations of BPA was 9.07 times higher than those with the lowest concentrations of BPA(OR=9.07,95%CI:2.82-29.14).Moreover,negative correlations were found between urinary BPA concentrations and basal FSH level (r=-0.235,P=0.005) or peak FSH level (r=-0.171,P=0.044) in girls with ICCP. Conclusion BPA exposure is associated with an increasing risk of ICPP in school-age girls,and the potential mechanism may be attributed to the relatively low level of FSH.

Genetic analysis of 43 children with hyperphenylalaninemia in some regions of Sichuan

ZHANG Ya-guo, YE Piao, OU Ming-cai, YANG Yun-xia, CHEN Xue-lian, YANG Li-juan

2020, 28(11):  1255-1258.  DOI: 10.11852/zgetbjzz2020-0855

Asbtract ( )   PDF (471KB) ( )  

References | Related Articles | Metrics

Objective To investigate the characteristics of gene mutations in children with hyperphenylalaninemia(HPA) in some regions of Sichuan, so as to provide basis for genetic diagnosis, prenatal diagnosis and genetic counseling of patients. Method PAH, PTS, QDPR, PCBD1, SPR and GCH1 genes of 43 HPA children were analyzed by next-generation sequencing technology (NGS). Results Totally 35 cases with PAH gene mutation and 8 cases with PTS gene mutation were detected.The most common mutations of PAH in the top three were p.R243Q, p.R241C and p.Ex6-96A>G.Finally 28 mutations (39.4%) were identified in exon 7.The p.G272V mutation of PAH had not been reported previously.The p.P87S, p.Y27Rfs*8, p.D96N and p.V56M mutations were the most common mutations of PTS.And 8 mutations (50.0%) were identified in exon 5.The p.T58R mutation of PTS was not reported previously. Conclusion The mutational spectrum of HPA-related genes in some regions of Sichuan is preliminarily constructed in this study, and a new mutation is detected in PAH and PTS respectively, which will provide reliable basis for genetic diagnosis and genetic counseling of patients with HPA in this region.

Analysis on the relationship between gastrointestinal symptoms and behavioral manifestations in children with autism spectrum disorder

LI Yu-qin, SUN Ying-hong, LIANG Ya-peng, ZHOU Fan, YANG Jie, JIN Sheng-li, LIANG Shuang

2020, 28(11):  1259-1262.  DOI: 10.11852/zgetbjzz2020-0412

Asbtract ( )   PDF (510KB) ( )  

References | Related Articles | Metrics

Objective To investigate the detection rate of gastrointestinal symptoms,and to analyze the association between gastrointestinal symptoms and behavioral manifestations in children with autism spectrum disorder(ASD),so as to provide new ideas for the intervention of ASD. Methods A total of 112 ASD children diagnosed according to the fifth edition of Diagnostic and Statistical Manual for Mental Disorders and 100 normal controls in the Department of Pediatrics of the Affiliated Hospital of Jiangsu University were enrolled in this study from January 2017 to December 2019.Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) were used to assess the symptoms of autistic children,Gesell Development Scale (GDS) was used to evaluate the development of autistic children,and questionnaire was used to investigate the occurrence of gastrointestinal symptoms and behavior performance in children. Results The detection rate of gastrointestinal symptoms in ASD group was significantly higher than that in control group (72.3% vs.24.0%,χ²=33.012,P<0.001).ASD children were divided into the gastrointestinal symptoms group (n=62) and the gastrointestinal symptoms-free group (n=50).The differences of GDS,CARS and ABC between the two groups were not statistically significant (P>0.05).However,the score of emotional problems,behavioral problems,stereotypies or repetitive behaviors and the overall score in the gastrointestinal symptoms group were significantly higher than those in gastrointestinal symptoms-free group (t=4.868,4.101,4.812,5.968,P＜0.001). Conclusions The prevalence of gastrointestinal symptoms in ASD children is significantly higher than that in typical children.ASD children with gastrointestinal symptoms have more serious emotional and behavioral problems than children without gastrointestinal symptoms,indicating that clinical intervention of gastrointestinal symptoms may be of great significance to the rehabilitation of ASD children.

Clinical analysis of improving hypothermia of premature infants in NICU by quality improvement program

YANG Chun-yan, SHEN Qing-hua, LI Cong, LIU Feng-min, MA Jing, XU Ping, YANG Qiao-zhi, SONG Xiao-yan

2020, 28(11):  1263-1266.  DOI: 10.11852/zgetbjzz2019-1411

Asbtract ( )   PDF (577KB) ( )  

References | Related Articles | Metrics

Objective To analyze the effect of quality improvement item (QI) on the incidence of hypothermia of very low birth weight premature infants in Neonatal Intensive Care Unit (NICU),in order to provide evidence for improving the clinical outcome of premature infants. Methods The very low birth weight premature infants (gestational age＜32 weeks and/or birth weight＜1 500 g) admitted to NICU in Liaocheng People's Hospital were enrolled in this study from 1st January,2017 to 31st January,2019.Infants whose annal temperature was lower than 36.5℃ were diagnosed with hypothermia.Infants admitted in this hospital from 1st January,2017 to 31st December,2017 were enrolled in control group(n=128),and received typical measures controlling temperature.And infants admitted in this hospital from 1st February,2018 to 31st January,2019 were selected as intervention group(n=120),whose temperature was administered through quality improvement program.The rates of prenatal conditions,hypothermia,intraventricular hemorrhage and morbidity were compared between the two groups. Results The rate of hypothermia in very low birth weight premature infants decreased from 92.5% to 40.5% during the intervention period,and the temperature of intervention group at admission was significantly higher than that of control group[(36.6±0.7) ℃ vs.(35.9±0.8)℃,t=4.54,P＜0.01)].The incidence of hypotension(43.4%) and intracranial hemorrhage(43.3%),the application of pulmonary surfactant (26.1%) and the incidence of sepsis(24.0%)in intervention group were significantly lower than those in control group (29.5%,32.9%,65.6%,41.0%,χ²=3.56,5.99,7.56,12.15,P＜0.05). Conclusion The implementation of quality improvement program based on evidence-based medicine can significantly reduce hypothermia of very low birth weight premature infants at admission and improve their clinical outcomes.

Predictive value of early amplitude integrated electroencephalography on neurodevelopmental outcomes in neonates with severe hyperbilirubinemia

YANG Yao, TAN Hui-yue, YU Xin-qiao

2020, 28(11):  1267-1270.  DOI: 10.11852/zgetbjzz2020-0243

Asbtract ( )   PDF (513KB) ( )  

References | Related Articles | Metrics

Objective To explore the predictive value of early amplitude integrated electroencephalography (aEEG) on neurodevelopmental outcomes in neonates with severe hyperbilirubinemia. Methods A total of 86 neonates with severe hyperbilirubinemia admitted to the neonatal intensive care unit of Enshi Central Hospital from December 2016 to December 2018 were selected as the research subjects.The basic clinical characteristics of the children were recorded.All children underwent aEEG, MRI, or auditory brainstem response (ABR) examination, and were followed up for 12 consecutive months to evaluate the neurodevelopmental outcomes of the children. Results Among the 72 (83.7%) children who were followed up, 16 (22.2%) children had adverse neurodevelopmental outcomes.Compared with children with good neurodevelopmental outcomes, children with poor developmental outcomes had significantly higher total serum bilirubin level, total serum bilirubin/serum albumin ratios, BIND scores>3, and exchange transfusion rates (P<0.05).The results of abnormal aEEG, ABR examinations, and the results of aEEG combined with ABR as well as MRI combined with ABR abnormalities were significantly correlated with adverse neurodevelopmental outcomes in children (P<0.05).Logistic regression analysis showed that aEEG abnormalities (OR=6.898,95%CI:1.047—45.563) and ABR abnormalities (OR=16.998,95%CI:2.685—107.608) were important risk factors for adverse neurodevelopmental outcomes in children.The sensitivity of abnormal aEEG and abnormal ABR to the prediction of neonatal adverse neurodevelopmental outcomes was 56.25% and 85.71%, specificity was 91.07% and 73.33%, accuracy was 83.33% and 77.27%, positive predictive values was 64.29% and 60.00%, and negative predictive value was 87.93% and 91.67%, respectively. Conclusion Early aEEG may predict adverse neurodevelopmental outcomes in neonates with severe hyperbilirubinemia, with higher specificity but lower sensitivity than ABR.

Study on bone mineral density level and its influencing factors in obese school-age children

ZHANG Jin, ZHANG Tian, SUN Hui-hui, SHANG Ran, SHI Wei-jia, DENG Yu-kun, HE Yue-hui, WAN Nai-jun

2020, 28(11):  1271-1275.  DOI: 10.11852/zgetbjzz2020-0452

Asbtract ( )   PDF (639KB) ( )  

References | Related Articles | Metrics

Objective To investigate changes and influencing factors of bone mineral density (BMD) in school-aged children with obesity. Methods A total of 96 school-age children (aged 6 to12 years) who visited the pediatric department of Beijing Jishuitan Hospital from October 2018 to October 2019, were enrolled in this study to complete a questionnaire survey.A series of physical examination were performed for these participants, including body composition, BMD of both distal ulnar and radius, abdominal ultrasound, blood level of lipids, calcium, vitamin D and fasting insulin.SPSS 25.0 software was used for statistical analysis. Results The average age of 96 children was (9.10±1.88) years old.There was no significant difference on BMD between left and right distal ulnar and radius, or between boys and girls (P>0.05).BMD of 10- to 12-year-old children was significantly higher than that in children aged 6-7 years and 8-9 years(H=13.917,P＜0.05).Age and muscle mass were both positively correlated with BMD of obese school-age children (r=0.359, 0.315, P<0.05), while the levels of total cholesterol, triglyceride, low density lipoprotein-cholesterol and calcium were negatively related to BMD (r=-0.311, -0.203, -0.246, -0.207, P<0.05).Milk and dairy products, carbonated beverage, moderate exercise, sunlight exposure and sedentary time were found to be influencing factors of BMD (P<0.05).Multiple linear regression analysis showed that sunlight exposure time was an independent factor affecting BMD(β=0.036, t=2.836, P< 0.05). Conclusion BMD increases with age for obese school-aged children.Dietary and environmental factors are important contributors to ensure the healthy growth of BMD.

Application and clinical significance of ultrasound in the diagnosis of hip dysplasia in children

DENG Xiong-feng, YANG Li, WANG Yuan-fang, FANG Xiang

2020, 28(11):  1276-1278.  DOI: 10.11852/zgetbjzz2019-1638

Asbtract ( )   PDF (450KB) ( )  

References | Related Articles | Metrics

Objective To analyze the application of ultrasonic examination in the diagnosis of dysplasia of hip joint in children,so as to provide reference for clinical practice. Methods A total of 360 children with screening result of hip joint dysplasia were selected in Yiling Maternal and Child Health Hospital from January to December 2018,and took further X-ray examination and ultrasonic examination.The final clinical diagnosis and follow-up for 6 months in all children were used as the gold standard for comparison. Results Finally 29 (8.1%) of 360 infants were diagnosed with hip dysplasia.The diagnostic accuracy ratios of X-ray examination and ultrasonic examination were 98.6% (355/360) and 99.4% (358/360).The diagnostic sensitivity and specificity of the X-ray group were 99.7% and 99.1%,respectively.The diagnostic sensitivity and specificity of ultrasonic examination group were 96.5% and 91.9%,respectively.The diagnostic sensitivity and specificity of ultrasonic examination were slightly higher than that of X-ray examination,but there were no significant differences (P>0.05).Among 360 infants,331 (91.9%) were of type I (normal hip joint),and 22(75.9%) infants were detected with type Ⅱ (immature) hip physiological development,of whom 15 infants changed to type I (normal hip),2 infants had no change,and 5 infants lost during the follow-up. Conclusions X-ray and ultrasonic examination can diagnose hip dysplasia accurately.Compared with X-ray examination,ultrasonic examination can effectively reduce or avoid excessive exposure to X-ray radiation in the process of examination,which is of higher clinical promotion value.

Predictive value of the change rate of procalcitonin for pulmonary infection in neonates

HUANG Yi-e, LI Meng-na, WU Li-juan, ZHANG Lian

2020, 28(11):  1279-1282.  DOI: 10.11852/zgetbjzz2019-1716

Asbtract ( )   PDF (613KB) ( )  

References | Related Articles | Metrics

Objective To analyze the predictive value of the change rate of procalcitonin for pulmonary infection in neonates,so as to provide basis for early identification of critical newborns. Methods A total of 400 newborns complicated with pulmonary infection in Shenzhen Baoan District Maternal and Child Health Hospital were enrolled in this study from July 2018 to August 2019.The levels of procalcitonin at admission and 24 hours later were measured and compared.The change rate of procalcitonin in children was calculated[(procalcitonin at admission at 24 h-procalcitonin at admission) / procalcitonin at admission].According to the change rate of procalcitonin,all children were divided into control group(change rate of procalcitonin≤0.00%) and observation group(change rate of procalcitonin>0.00%),with 200 cases in each group.The levels of C-reactive protein (CRP) and vitamin A in the two groups of neonates were tested,and then the predictive value of C-reactive protein,vitamin A and procalcitonin rate in neonates with pulmonary infection were compared. Results Compared with the control group,the C-reactive protein content in the neonates was significantly lower(t=-30.601),while the vitamin A content was significantly higher(t=-15.460) in the observation group.Furthermore,the length of stay was significantly longer(t=13.783) and the incidence of sepsis was significantly higher(χ²=4.712,P<0.05) in the observation group.In addition,the area under the curve of procalcitonin change rate in diagnosing of pulmonary infection complicated with sepsis in newborns was 0.821 (95%CI:0.803-0.878,P<0.05),which was higher than that of C-reactive protein and vitamin A. Conclusion The change rate of procalcitonin has a significant predictive value for neonatal pulmonary infection.

Correlation of neonatal asphyxia with blood lactic acid and myocardial enzyme levels

FENG Zu-zhang, SUN Li

2020, 28(11):  1283-1285.  DOI: 10.11852/zgetbjzz2019-0849

Asbtract ( )   PDF (427KB) ( )  

References | Related Articles | Metrics

Objective To analyze the correlation of neonatal asphyxia with blood lactic acid and myocardial enzyme levels, in order to provide reference for early diagnosis and treatment of neonatal asphyxia. Methods A total of 80 full-term neonates were selected in Xiantao First People's Hospital Affiliated to Changjiang University from June, 2014 to June, 2017, and were divided into mild asphyxia group(n=19)due to mild asphyxia,severe asphyxia group(n=21) due to severe dsphyxia and control group(n=40).Serum lactate and myocardial enzyme levels, including serum aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), were tested and compared within 1 hour and 24 hours after birth among three groups. Results Serum lactate and myocardial enzyme levels in 1 hour and 24 hours after birth in mild asphyxia group and severe asphyxia group were significantly higher those in control group(P＜0.05 or <0.01), which were also markedly higher in severe asphyxia group than that in mild asphyxia group(P＜0.01). Conclusions Neonatal asphyxia can cause myocardial injury, and severe asphyxia will lead to more serious myocardial injury.Test of blood lactic acid and myocardial enzyme levels can help the clinical determination of key indicators for neonatal asphyxia and the severity of the initial diagnosis, which is conducive to the diagnosis and treatment of neonatal asphyxia, and is worthy of being widely applied.

Study on the application value of neuron specific enolase, amplitude integrated electroencephalograghy and video electroencephalogram in term infants with different blood glucose levels

CHEN Xi, WANG Yong-qin, ZHAO Yue-hua

2020, 28(11):  1286-1289.  DOI: 10.11852/zgetbjzz2020-1750

Asbtract ( )   PDF (535KB) ( )  

References | Related Articles | Metrics

Objective To analyze the change trend and characteristics of neuron specific enolase (NSE), amplitude integrated electroencephalograghy (aEEG) and video electroencephalogram (VEEG) in term infants, in order to provide clinical reference for assessing brain injury and brain function changes in term infants with different blood glucose levels. Methods A total of 83 full-term neonates diagnosed with neonatal hypoglycemia were selected from the Affiliated Hospital of Weifang Medical College from January to August 2019.According to the minimum blood glucose level, the objects were divided into mild hypoglycemia group (39 cases)(2.2 mmol/L≤blood glucose＜2.8 mmol/L), moderate hypoglycemia group(31 cases) (1.1 mmol/L≤blood glucose＜2.2 mmol/L) and severe hypoglycemia group(13 cases) (blood glucose＜1.1 mmol/L).Meanwhile, 40 neonates with normal blood glucose with high risk factors were selected as control group.Children with hypoglycemia were tested every 3 hour.aEEG was performed 6 hours after that two consecutive blood glucose tests were in normal range.Newborns in control group were given 6 hours of aEEG in 72 hours.VEEG was detected in both groups within 12 hours after aEEG.Serum NSE levels were measured on the 1st, 3rd and 5th day.Rank sum test was used for aEEG and VEEG, t test was used for the change of NSE, and F test was used for intergroup comparisons. Results 1) The incidence of pregnancy-induced maternal blood glucose elevation was statistically significant among each group (P=0.03).2) The level of NSE in neonates with hypoglycemia was higher.There were significant differences on NSE level among children with different blood glucose levels (F=965.759, P<0.001), and there was an interaction effect on NSE level between time and blood glucose values (F=31.14,P＜0.001).3)There were significant differences on sleep-wake cycle(SWC) and total score of aEEG among mild, moderate and severe hypoglycemia groups (H=25.192,17.824, P＜0.01).The total score, SWC and bandwidth in severe hypoglycemia group were significantly lower than those of control group(U=113.0, 111.5, 188.0), and the total score and SWC were lower than those in mild hypoglycemia group (U=132.5, 110.5,P＜0.05).The total score and presence of cyclic changes in electrical activity of moderate hypoglycemia group were significantly lower than those of control group (U=366.0, 348.5)and mild hypoglycemia group (U =420.5, 344.5, P＜0.05).4) VEEG result was normal in all groups. Conclusions NSE level is different in children with different blood glucose levels, which can be used as an index to evaluate the possibility and degree of brain injury in children with simple hypoglycemia.Moderate and severe hypoglycemia can lead to changes in neonatal aEEG, mainly in SWC changes.However, VEEG can not be a sensitive index for hypoglycemia.

Application of amplitude-integrated electroencephalogram combined with serum neuron specificenolase and S100-β levels in the diagnosis of premature infants withcerebral injury

WANG Yan-rui, WANG Gui-fang

2020, 28(11):  1290-1293.  DOI: 10.11852/zgetbjzz2019-1892

Asbtract ( )   PDF (579KB) ( )  

References | Related Articles | Metrics

Objective To analyze the diagnostic value of amplitude-integrated electroencephalogram (aEEG) combined with serum neuron-specific enolase (NSE) and S100-β protein levels in the diagnosis of cerebral injury in premature infants, so as to provide clinical basis for the early diagnosis. Methods A total of 98 premature infants with high-risk factors for cerebral injury in neonatal wards of Xinxiang Central Hospital from May 2016 to May 2018 were selected as participants in this study.According to the diagnostic criteria in Expert Consensus for Diagnosis and Prevention of Brain Injury in Premature Infants, the premature infants were divided into cerebral injury group (n=56) and non-cerebral injury group (n=42).And aEEG was performed in all neonates, and serum levels of NSE and S100-β protein were tested.The sensitivity, specificity, and accuracy of single indicator detection and combined detection of aEEG, serum NSE and S100-β in the diagnosis of premature infants with cerebral injury were analyzed and compared.Then the receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC value) was recorded. Results The sensitivity values of single indicator detection and combined detection of aEEG, serum NSE and S100-β in the diagnosis of premature infants with cerebral injury were 82.14%, 71.43%, 69.64%, and 94.64%, respectively; The specificity values were 66.67%, 80.95%, 76.19%, and 61.90%, respectively; The accuracy rates were 75.51%, 75.51%, 72.45%, and 80.61%, respectively, and the AUC values were 0.744, 0.762, 0.729 and 0.783, respectively.It was indicated that the combined detection could significantly improve the sensitivity (P<0.05). Conclusion aEEG, serum NSE and S100-β can be used as diagnostic indicators for premature infants with cerebral injury, and combined detection of the three indexes can significantly improve the diagnostic efficacy.

Effect of whole-body vibration training and combined with belly band for motor function of children with spastic cerebral palsy

LI Xin, YU Li-mei, LONG Yao-bin

2020, 28(11):  1294-1297.  DOI: 10.11852/zgetbjzz2020-0503

Asbtract ( )   PDF (642KB) ( )  

References | Related Articles | Metrics

Objective To investigate the application of whole-body vibration training and belly band for motor function of children with spastic cerebral palsy (CP), in order to provide reference for the rehabilitation treatment. Methods A total of 90 children with spastic CP admitted to the Second Hospital Affiliated to Guangxi Medical University were enrolled in this study from June, 2018 to May, 2019,and were randomly divided into three groups, including convention group(n=30), convention-vibration training group(n=30), convention-band-vibration training group (n=30) .The motor function among three groups were evaluated and compared before and after intervention. Results 1)After treatment, the scores of indicators all markedly improved among three groups (P<0.05).2)Univariate analysis indicated that there were significant difference on the number of ankle's range of motion, scores of manual muscle test(MMT), Modified Ashworth Scale (MAS), Pediatric Balance Scale(PBS), C,D,E zone of Gross Motor Function Measure(GMFM), Pediatric Evaluation of Disability Inventory(PEDI), 6-minute walk test (6MWT) among three groups(F=14.278,26.886,14.149,25.883,3.769,4.254,6.512,5.194,6.982,P<0.05).In addition, the improvement of these indicators in convention-vibration training group was greater than that in other two groups (P<0.05). Conclusion Whole-body vibration training combined with belly band can improve the motion function and spastic level for spastic cerebral palsy more effectively.