Table of Content

10 December 2020, Volume 28 Issue 12

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Focusing on visual or hearing impairment and early intervention for high-risk infants

TONG Mei-ling

2020, 28(12):  1301-1304.  DOI: 10.11852/zgetbjzz2020-1688

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High-risk children have a much higher risk of developing visual or hearing impairment than normal children.Visual or hearing impairment can have a significant impact on children′s motor, language, cognition, emotion, social communication and other aspects of development.Focusing on monitoring and early intervention in high-risk children will minimize the degree of visual or hearing impairment and the negative impact of this disorder on children, and help promote the early development of children.

Study of the effect of gestational age on neurobehavioral ability of infants

CUI Wei, DAI Xiao-tian, LIN Sen-ran, GU Gui-xiong, HUA Jing

2020, 28(12):  1305-1308.  DOI: 10.11852/zgetbjzz2020-0756

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Objective To explore the influence of different gestational ages on infants′ motor and cognitive neurobehavioral abilities, in order to provide clues for the adjustment of child health care service model after the two-child policy. Methods A total of 2 646 infants and young children who underwent physical examinations in a district hospital in Shanghai from January to April 2017 were investigated by a convenience sampling method using the Bayley Ⅲ Screening Scale. Results There were significant differences in gross motor, fine motor and cognitive development between children born to women with advanced age and younger women(t=2.94, 2.80, 2.68, P＜0.05).After adjusted for maternal age, gender, birth weight and gestational age, Logistic regression analysis showed that the risk of gross motor development retardation in preterm infants was 1.960 times higher than that in full-term infants(OR=1.960, 95%CI:1.264-3.037).The risk of fine motor in early term infants were 1.192 times higher than that in full-berm infants(OR=1.192, 95%CI:1.006-1.412). Conclusion Compared with full term infants, preterm infants have an increased risk of gross motor retardation, and early term infants have an increased risk of fine motor retardation.

Study of the application of the Alberta Infant Motor Scale in the follow-up of high-risk infants

BIAN Shan-shan, LI Hai-xin, WANG Huai-yan

2020, 28(12):  1309-1312.  DOI: 10.11852/zgetbjzz2020-1073

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Objective To analyze the parallel validity of the Alberta Infant Motor Scale(AIMS) and Gesell Development Diagnosis Scale(GDDS), and to primarily set the percentile reference value of AIMS in judging motor developmental abnormalities of high-risk infants. Methods From January 2017 to February 2018, a total of 268 high-risk infants who underwent physical examination in Department of Child Health, Changzhou Maternal and Child Health Care Hospital were enrolled in this study, and were assessed by AIMS and GDDS.The percentile of AIMS and gross movement development quotient(DQ) in GDDS were used to test the parallel validity.All the high-risk infants were divided into full-term group and premature group, and the premature group was then divided into three groups according to month of age.Then the Spearman correlation coefficient and Kappa value of GDDS and AIMS in determining motor developmental abnormalities among each group were calculated. Results When taking P₁₀ as the value for determining motor developmental abnormalities in full-term high-risk infants, the parallel validity with GDDS was the best, showing a high consistency between AIMS and GDDS(Kappa＝0.759,P<0.001).For high-risk infants aged 6 months or younger, the correlation and consistency between AIMS and GDDS were poor under any criteria.For preterm high-risk infants aged 7—12 months, when the AIMS percentile was＜P₂₅ for the motor developmental abnormalities, the correlation coefficient and Kappa value were 0.779 and 0.766, respectively, showing a good correlation and high consistency.However, it was only moderately correlated and consistent when taking AIMS＜P₅ and ＜P₁₀ as the value of the developmental abnormalities.For preterm high-risk infants over 12 months old, when taking AIMS ＜P₁₀ as the value of the developmental abnormalities, the correlation coefficient and Kappa value were the highest. Conclusions AIMS and Beijing version of GDDS are highly consistent and correlated quantitatively and qualitatively.For full-term high-risk infants and premature high-risk infants over 1 year old, <P₁₀ can be taken as the reference value for judging motor developmental abnormalities.AIMS can more sensitively detect motor developmental abnormalities for premature high-risk infants within 1 year old.When using the percentile of AIMS to determine motor developmental abnormalities, it is still necessary to comprehensively consider for determining the appropriate time of early intervention.

Effects of early comprehensive intervention on motor and cognitive development of high-risk infants

LIN Ling, ZHANG Li-shan, ZHANG Yi-wen, XU Lei, WANG Di, WANG Hui-yu

2020, 28(12):  1313-1316.  DOI: 10.11852/zgetbjzz2020-1083

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Objective To analyze the effects of early comprehensive intervention on motor and cognitive development of high-risk infants during the first year, so as to provide reference for the systematic management of high-risk infants after discharge. Methods A stratified random cluster sampling method was adopted to select high-risk infants(premature infants and low birth weight infants) born from January to September 2018 from 16 communities in Pudong District.The high-risk infants were registered for physical examination in the corresponding communities, and were divided into the control group and the intervention group.Both groups carried out routine management of high-risk infants according to the “Shanghai Child Health Care Work Standard”, and the intervention group received comprehensive intervention additionally.Motor and cognitive development of the two groups was compared. Results The fine motor development of the intervention group was higher than that of the control group at the aged of 6 months old(t=2.074, P<0.05).The cognition development of the intervention group was higher than that of the control group at 12 months(t=2.353, P<0.05).The increase velocity of the social-skills development in the intervention group was higher than that in the control group(t=2.474, P<0.05). Conclusions The early comprehensive intervention integrated hospital and home can facilitate the motor and cognitive development of high-risk infants.Further follow-up studies are warranted to explore the long-term effects of comprehensive intervention on development.

Study on the value of modified amplitude-integrated electroencephalography score combined with biochemical markers in early diagnosis of high-risk neonatal brain injury

FENG Hui-min, JI Jing-lei, FENG Cai-li, FAN Xue-ai

2020, 28(12):  1317-1321.  DOI: 10.11852/zgetbjzz2020-1035

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Objective To explore the value of modified amplitude-integrated electroencephalography (aEEG) score combined with biochemical markers in the early diagnosis of high-risk neonatal brain injury, so as to provide evidence for its early diagnosis. Methods Data of 145 high-risk neonates treated in the Third Hospital of Xingtai from June 2017 to May 2019 were selected for retrospective analysis.The results of aEEG test of children were collected and assessed by modified aEEG score, Neonatal Critical Illness Score (NCIS) and biochemical marker test results of brain injury.Children were divided into two groups according whether with brain injury or not, and the modified aEEG score, NCIS score and biochemical markers of brain injury were compared between the two groups.The correlation between modified aEEG score, brain injury biochemical markers and NCIS score was analyzed.ROC method was used to analyze the value of modified aEEG score combined with biochemical markers in the early diagnosis of high-risk neonatal brain injury. Results Among the 145 children in this study, 79 were diagnosed with brain injury and 66 had no brain injury.There were no significant differences on gestational age, gender and delivery methods between the two groups (P>0.05).The birth weight and 1min Apgar score of children with brain injury were significantly lower than those of brain injury (t=-3.149,-8.401,P<0.05).The modified aEEG score, the levels of NSE and GFAP of brain injury group were significantly higher than those of non-brain injury group, and NCIS score and BDNF level of brain injury group were significantly lower than those of non-brain injury group(P<0.05).Correlation analysis results showed that the NCIS score was negatively related to modified aEEG score, NSE, GFAP levels(r=-0.618,-0.694,-0.583, P<0.05), while the level of BDNF was positively correlated with NCIS score (r=0.648, P<0.05).ROC analysis results showed the cut-off value of aEEG score for early diagnosis of high-risk neonatal brain injury was 9.18(AUC=0.902, 95%CI: 0.845-0.959).Similarly, the cut-off value of NSE was 15.04 μg/L (AUC=0.885, 95%CI: 0.821-0.949),the cut-off value of BDNF was 1.16 ng/ml(AUC=0.894, 95%CI: 0.834-0.954), and the cut-off value of GFAP was 4.61 ng/L(AUC=0.764, 95%CI: 0.666-0.862).And combined diagnosis can effectively improve the diagnostic sensitivity (sensitivity: 89.87%, specificity: 75.76%, P<0.05). Conclusions The modified aEEG score, NSE, BDNF and GFAP levels of high-risk neonates with brain injury can be significantly abnormal, which are significantly related to the severity of illness in children.AEEG score, NSE, BDNF and GFAP are all of high value in early diagnosis of high-risk neonates with brain injury, and the combination can improve the sensitivity of diagnosis.

Study on the relationship between docosahexaenoic acid and children′s allergic diseases in early life

WANG Qian, ZHU Sui, HU Fang

2020, 28(12):  1322-1327.  DOI: 10.11852/zgetbjzz2020-1097

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Objective To discuss the relationship between docosahexaenoic acid (DHA) supplementation during pregnancy and offspring′s allergic diseases,in order to provide new ideas for the prevention and treatment of allergic diseases in infants. Methods From June 2017 to November 2018, totally 806 children who were born and took child health care in Guangzhou Women and Children′s Medical Center were enrolled in this study.Food frequency questionnaires, child allergic diseases questionnaires were used to obtain the diet patterns during pregnancy and lactation, DHA supplementation information, and screening of children with suspected allergic diseases.The diagnosis of specific IgE antibodies was performed in children with suspected allergic diseases. Results Among the 806 children, the incidence of allergic disease was 26.2%(211/806), of which the incidence of eczema and food allergy was 23.0%(185/806) and 8.7%(70/806), respectively.The risk of allergic diseases(OR=0.10,95%CI:0.01-0.79) and eczema(OR=0.02, 95%CI:0.01—0.20) in children decreased with the increasing dose of maternal DHA supplementation when the dose was greater than 250 mg/d during pregnancy(P<0.05).Mothers′ history of allergy increased the risk of allergic diseases, eczema, food allergies in the offspring(OR=4.09, 23.75, 14.71,P<0.05). Conclusion Maternal DHA supplementation at a certain dose during pregnancy may be a protective factor against allergic disease in children, but the relationship between DHA supplementation and food allergy needs to be further explored.

Vocabulary list design and its efficacy in vocabulary teaching of autistic children

LIU Dai-yue, WANG Bi-jun, GUO Yan-qing

2020, 28(12):  1328-1332.  DOI: 10.11852/zgetbjzz2020-0364

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Objective To develop a set of word lists suitable for Chinese autism spectrum disorder (ASD) children learning nouns,and to assess its feasibility,so as to provide materials for language training of ASD children. Methods Totally 480 nouns most commonly used in daily life were selected,and were divided into low,medium,high difficulty levels.Afterwards 121 representative words were selected and the content rationality was evaluated by 3 experts.Then the word list was used to assess the understanding and expression level of 195 ASD children aged 2-8 years and 130 children with normal development by parent self-assessment report,thus the availability was tested. Results 1) The vocabulary list developed in this study was appropriate for ASD children and the difficulty setting was reasonable.2) At the group level,there was no significant difference on the comprehension and expression ability of normal children (t=1.748,P=0.083),and the comprehension ability of ASD children was significantly better than that of expression ability (t=18.31,P<0.001). At the individual level,there was individual heterogeneity in the development of comprehension and expression ability in both groups.3) The results of multivariate analysis of variance within the two groups showed that in the normal children group,the main effect of difficulty was significant (F=204.67,P<0.001),the main effect of age was significant (F=37.40,,P<0.001),and the interaction between difficulty and age was significant (F=12.20,P<0.001).In ASD children,the main effect of difficulty was significant (F=234.48,P<0.001),the main effect of age was significant (F=17.20,P<0.001),and the interaction between the two was significant (F=4.95,P<0.001). Conclusions This study is the first to design a noun word list suitable for language teaching of ASD children,which was proven with reasonable content and difficulty.Moreover,it can well assess whether children′s vocabulary expression and comprehension levels are synchronized,and distinguish children with different levels of vocabulary development in both normal children and ASD children.

Influence of different interventions on early integrated development of children aged 0 to 3 years

LI Yu-yan, WU Jun-qing, JIANG Nan, WANG Xing, LI Yi-ran, ZHAO Rui, ZHOU Ying

2020, 28(12):  1333-1337.  DOI: 10.11852/zgetbjzz2020-0966

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Objective To understand the influence of different intervention modes on early integrated development of children aged 0 to 3 years, in order to provide scientific basis for the work on early childhood development. Methods Totally 295 infants and toddlers were enrolled in this study in September 2018, and were divided in to control group (n=97), family intervention group (n=100) and community intervention group (n=98) according to the different interventions.Early integrated development was evaluated by specialized persons using Early Learning Accommodation Profile (E-LAP) and Learning Accommodation Profile Diagnostic (LAP-D).The rate of the assessed developmental month age older than or equal to the actual month age was defined as better development and an evaluation index to evaluate the intervention effect. Results After family intervention, there were significant differences on better gross motor, fine motor, cognitive, language development and social skills (χ²=39.111,27.604,30.083,12.562,13.657,P＜0.05).While significant difference existed only on gross motor and language in the community intervention group (χ²=4.015,5.227,P＜0.05).In control group, there was significant difference on gross motor (χ²=7.009,P＜0.05).After adjusting children′s age, maternal age, and parental education, the generalized estimation equation model showed that compared with the control group, the family intervention group has a significantly higher ratio of better development in gross motor, fine motor and cognitive dimension(OR _gross=1.859,OR _fine=2.942,OR _cognitive=1.813, P＜0.05).Community intervention group only had significant difference in better gross motor development(OR_gross=1.751, P＜0.05).There was no significant difference on language and social skills among different intervention groups (P>0.05). Conclusion Early intervention programmes for infants and toddlers aged 0-3 years, especially the family interventions, could effectively promote integrated early development.

Effect of CpG ODN combined with HSP70/CD80 DNA vaccine on serum levels of IL-4, IL-13,IFN-γ and the levels of IL-4, IL-25 and IL-33 in bronchoalveolar lavage fluid of asthmatic mice

WANG Hui-yuan, LI Jing, GENG Yan, HAO Juan-juan, ZHANG Yang, HOU Wei

2020, 28(12):  1338-1342.  DOI: 10.11852/zgetbjzz2020-0887

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Objective To study the effect of non-methylated CpG oligodeoxynucleotide (cytosine-phosphate-guanosine-oligodeoxynucleotides, CpG ODN) combined with heat shock protein 70 (heat shock protein 70, HSP70)/CD80DNA vaccine on pulmonary inflammation, serum levels of IL-4, IL-13, IFN-γ and the changes of IL-4, IL-25 and IL-33 in bronchoalveolar lavage fluid(BALF) of asthmatic mice, so as to provide experimental basis for the treatment of asthma by CpG ODN-HSP70/CD80DNA vaccine. Methods Ovalbumin (OVA) and aluminum hydroxide [Al (OH)₃] adjuvant were used to sensitize mice with asthma model.From June to September 2019,totally 32 BALB/c mice aged 6—8 weeks were selected and were randomly divided into four groups, including control group, asthma group, HSP70/CD80DNA vaccine group and combined vaccine group (CpG ODN combined with HSP70/CD80DNA vaccine group).HE staining was used to observe the pathological and morphological changes of lung tissue.The changes of serum levels of IL-4, IL-13, IFN-γ in and IL-4, IL-25, IL-33 in BALF were detected by ELISA. Results HE staining of lung tissue showed that the inflammatory response of lung tissue in combined vaccine group was significantly less than that in the asthma group, and the infiltration of inflammatory cells around the airway was significantly reduced.ELISA results showed that compared with the control group, serum levels of IL-4 and IL-13 in asthma group were significantly higher (P<0.05), and serum IFN-γ level was significantly lower (P<0.05).Compared with the asthma group, serum levels of IL-4 and IL-13 in the Hsp70/CD80DNA vaccine group and the combined vaccine group were significantly lower (P<0.05), and the serum IFN-γ level was significantly higher (P<0.05).Compared with the Hsp70/CD80DNA vaccine group, the serum levels of IL-4 and IL-13 in combined vaccine group were significantly decreased (P<0.05), and the serum IFN-γ were significantly increased (P<0.05).The results of BALF showed that compared with the control group, the levels of BALF IL-4, IL-25 and IL-33 in the asthma group were significantly increased (P<0.05).Compared with the asthma group, the levels of IL-4, IL-25 and IL-33 in BALF in the Hsp70/CD80 DNA vaccine group and the combined vaccine group were significantly decreased (P<0.05).And the levels of IL-33 in BALF in the combined vaccine group were significantly lower than those in the Hsp70/CD80 DNA vaccine group (P<0.05). Conclusion CpG ODN combined with Hsp70/CD80DNA vaccine can inhibit the production of IL-4, IL-13, IL-25 and IL-33 in mice, enhance the production of IFN-γ in mice, and reduce airway inflammation in asthmatic mice.

Disputes about catch-up growth of small for gestational age

LIU Ya-wen, CHENG Qian

2020, 28(12):  1343-1346.  DOI: 10.11852/zgetbjzz2019-1822

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Due to the removal of intrauterine malnutrition and postnatal nutrition supplementation,most children who are born small for gestational age (SGA) tend to experience catch-up growth (CUG) after birth.CUG demonstrates the growth potential of SGA and makes up for the defect of intrauterine growth retardation.However,it is inconclusive on the defining criteria of SGA and CUG,as well as the factors influencing CUG.This review combs the definition of SGA and CUG,analyzes the related influencing factors of CUG,so as to emphasize the importance of establishing standardized definitions for SGA and CUG.

Research progress on the mechanism of vitamin D in autism spectrum disorders

YANG Jing, HU Yan

2020, 28(12):  1347-1350.  DOI: 10.11852/zgetbjzz2019-1480

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder.At present,the pathogenesis of ASD is not clear,and there is no effective treatment.In recent years,many studies have shown that vitamin D plays an important role in brain development and the occurrence and development of ASD.This review combs the progress on the mechanisms of vitamin D in ASD.

Research progress on the role of nutritional supplements in the treatment of attention deficit hyperactivity disorder in children

ZHANG Yang, HU Bin, ZHANG Yu-ping

2020, 28(12):  1351-1354.  DOI: 10.11852/zgetbjzz2019-1444

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Attention deficit hyperactivity disorder(ADHD) is a common neurobehavioral disorder in children and adolescents,which may persist into adulthood.Insufficient supply of polyunsaturated fatty acids (PUFA) and minerals such as zinc,iron and magnesium has been considered to play an important role in the development of ADHD symptoms.This article reviews the research progress on PUFA and mineral nutrition supplements in the treatment of ADHD,and encourages clinicians to take appropriate screening and preventive measures on the basis of reviewing the dietary history of children with ADHD,so as to provide individualized treatment strategies for ADHD children.

Genetic typing and research progress of hypophosphatemic rickets

LI Na, WANG Lin, JIN Chun-hua

2020, 28(12):  1355-1359.  DOI: 10.11852/zgetbjzz2019-1596

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Hypophosphatemic rickets (HR),also known as familial hypophosphatemia or renal hypophosphatemic rickets,is a single gene genetic disease characterized by renal phosphate loss,vitamin D metabolism and bone mineralization disorders.According to whether the disease is regulated by FGF23,the disease can be divided into FGF23 dependent HR and non FGF23 dependent HR.At present,many specific pathogenic genes related to HR have been found,including X-linked,autosomal dominant and autosomal recessive.This paper reviews the genetic typing and research progress of vitamin D rickets.

Prevalence and influences of breast milk expression

HU Lu-dan

2020, 28(12):  1360-1362.  DOI: 10.11852/zgetbjzz2019-1978

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Expressing breast milk has become increasingly prevalent and has become an important part of breastfeeding.To some extent,breast milk expression is a helpful alternative for breastfeeding.In the past,expressed breast milk feeding was predominantly for those infants who were premature,small or unwell.However,it has become increasingly common in healthy term infants.To promote breastfeeding,this paper systematically analyzes the literature related to breast milk expressing by women who have infants,including the prevalence of breast milk expressing,reported reasons,methods and influences related to expressing.

Visualization study of researches on childhood tic disorder in China and abroad over the past five years

LIU Hai-ling, LIU Xiao-hong, YANG Yong-hua

2020, 28(12):  1363-1368.  DOI: 10.11852/zgetbjzz2020-1016

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Objective To introduce co-word analysis into the current situation studies on children′s tic disorder (TD), to analyze and compare the similarities and differences between domestic and foreign research directions over the past five years, and to find out the advantage and weakness of Chinese research status in this field. Methods The keywords were determined as “Tic Disorder” AND “child*”.Research papers that meet the research standards related to children with TD published from January 2015 to December 2019 were searched and screened in Pubmed, CNKI, VIP and Wanfang Databases.High frequency keywords were counted, and cluster analysis was conducted on them with SPSS 20.0.Co-occurrence analysis was conducted by using Ucinet 6.0 and Netdraw, and the co-occurrence relationship between high-frequency keywords was visualized. Results A total of 300 research articles related to children with TD were retrieved, including 206 in China and 94 in foreign countries.The co-occurrence analysis of high-frequency keywords in children′s TD research papers at home and abroad was conducted.The hot keywords in domestic literature included clinical efficacy, aripiprazole, risk factors, TCM therapy, etc and that in foreign literature included comorbidities, therapeutic efficacy, epidemiology, etc.The research direction of foreign countries was more novel and richer than domestic ones, which included more comorbidity, epidemiology and research methods than domestic research, and the keywords are more accurate and standardized.Domestic research was more concerned with research on drug efficacy and Chinese medicine treatment. Conclusions The overall research direction of children′s TD in China and abroad is basically similar.The foreign literature network diagram is more complicated, and the keywords are more standardized and accurate.The research and development of children′s tic disorder in China is in a good trend, and more researches are warranted in future in terms of comorbidities, epidemiology and research methods.

Analysis of the clinical value of early assessment and intervention in the follow-up of high-risk infants

ZHANG Yan, LI Ye-ping, LIU Ling

2020, 28(12):  1369-1373.  DOI: 10.11852/zgetbjzz2020-0760

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Objective To explore the clinical value of early assessment and intervention in the follow-up of high-risk infants, so as to provide a new model for follow-up and intervention of high-risk infants. Methods Totally 160 high-risk children in Child Health Department of Wuhu Second People′s Hospital were selected to perform General Movements assessment (GMs) in writhing stage and restless stage from October 2010 to October 2016.When infants were 3 months old, the developmental quotient (DQ) was regularly tested by the 0-6 Years Old Pediatric Examination Table of Neuropsychological Development (pediatric neuropsychological table for short).The neurodevelopmental outcomes of these children were confirmed by clinical diagnosis and follow-up evaluations after 12 months old.Then early intervention was performed in children with abnormal results.The self-control study was designed to observe the clinical effect, and the correlation between the two evaluation results and the related factors of early neuromotor development abnormality were analyzed. Results 1) In terms of neurological developmental outcomes, there were 59(36.8%) cases of normal development, 58(36.3%) cases of developmental deviation,32(20%) cases of developmental delay, and 11(6.9%) cases of cerebral palsy.2)The GMs evaluation result of the writhing movements stage before and after the early intervention was significantly different (χ²=35.367, P<0.01).3) Children′s DQ after intervention was significantly higher than that before intervention (t=-4.593, P<0.01).4) GMs assessment results was significantly related to the score of Pediatric Neuropsychological Scale (P<0.05 or<0.01).5) Logistic regression analysis showed that the high risk factors of abnormal evaluation result in the twisting stage included low birth weight(OR=7.650,95%CI:1.129-51.813,P＝0.037), hypoxic ischemicen cephalopatly(OR=2.656,95%CI:1.158-6.089,P＝0.021), brain injury (OR=2.123,95%CI:1.017-4.434,P＝0.045) and premature birth (OR=2.405,95%CI:1.126-5.133,P＝0.023). Conclusion Combination of GMs assessment and Pediatric Neuropsychological Scale is helpful to predict the neurological development outcomes of high-risk infants, which plays a guiding role in early intervention of high-risk infants.

Study on assessment and intervention mode of mild motor developmental retardation in preterm infants

ZHANG Guo-hua, YUAN Liu-fen, HUANG Qiao-lian, TU Lin, CHEN Chun-bi, LIU Shu-juan

2020, 28(12):  1374-1377.  DOI: 10.11852/zgetbjzz2019-02441

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Objective To analyze the assessment and early intervention mode of mild motor developmental delay in preterm infants,in order to provide a new mode for follow-up and intervention of preterm infants. Methods A total of 100 preterm infants with first follow-up card and routine follow-up from March 1st,2018 to March 31st,2019 in the Children′s Health Department of Affiliated Xiaolan Hospital,Southern Medical University were selected in this study,and were examined by 20 neuromotor examinations at 0-1 years (20-items).The preterm infants were divided into intervention group (n=33),control group (n=31) and normal group (n=32),and 4 cases of premature infants were referred.The Alberta Infant Motor Scale (AIMS) scores of the preterm infants in intervention group and control group were compared after intervention and the development quotient (DQ) of the three groups of preterm infants at the age of 12 months were compared. Results 1) After the intervention,AIMS score of the intervention group was significantly higher than that of the control group (t=2.06,P＜0.05).2) The gross motor DQ,verbal DQ,and social behavior DQ at 12 months old among the intervention group,normal group and control group were significantly different (F=9.49,9.02,4.53,P＜0.05).Further analysis showed that the difference on gross motor DQ between control group and normal group,as well as between control group and intervention group were both significant (P＜0.05).Differences on verbal DQ between intervention group and normal group,as well as between control group and normal group were significant (P＜0.05).Moreover,the difference on social behavior DQ between control group and normal group was significant (P＜0.05),but there was no statistically significant difference between the other groups (P＞0.05).3) Four cases of premature infants were referred and there were no infants with visual or hearing abnormalities. Conclusion The early comprehensive intervention mode based on 20 neuromotor examinations for follow-up,AIMS as the guidance for early intervention and the early interventions focused on Bobath therapy is feasible in the follow-up of premature infants with mild motor retardation.

Changes and significance of MUC1 and IL-11 expression in neonatal necrotizing enterocolitis tissues

BAI Qiong-dan, XU Bang-li, CHEN Xin-ya, YU Zeng-yuan

2020, 28(12):  1378-1381.  DOI: 10.11852/zgetbjzz2020-0632

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Objective To investigate the changes and significance of type 1 mucin (MUC1) and interleukin-11 (IL-11) in the intestinal mucosa of neonatal necrotizing enterocolitis(NEC), so as to provide evidence for the prevention and treatment of NEC in clinical practice. Methods From February 2015 to July 2019, a total of 65 cases of intestinal mucosal tissue samples of postoperative NEC children in Children′s Hospital of Zhengzhou University were collected and selected as NEC group, and 30 cases of colonic specimens obtained from surgical treatment of congenital megacolon during the same period were selected as the control group.Specimens of two groups were detected by immunohistochemical staining.The positive expression rates of MUC1 and IL-11 protein were analyzed and compared between the two groups. Results Immunohistochemical staining analysis indicated that the positive expression rates of MUC1 and IL-11 protein in colonic mucosa of children in NEC group were 47.69% and 53.85%,respectively, which were 80.00% and 83.33% in control group, and the difference was significant(χ² =8.789, 7.670, P＜0.05).The positive expression rate of MUC1 and IL-11 protein in colonic mucosa were 33.33% and 40.00%, respectively, which were 60.00% and 65.71% in control group, and the difference was significant(χ² =4.605, 4.298, P＜0.05). Conclusions The expression of MUC1 and IL-11 protein in the intestinal mucosa of NEC children are significantly down-regulated, and the expression is more significantly down-regulated in the tissues with higher disease stages.Therefore, it is speculated that the decreased expression of these two proteins may be involved in the development of NEC.

Hearing evaluation of transferred infants that failed in hearing screening in Xinjiang

HOU Xiao-juan, LU Jin-shan, ZHANG Lun, DING Wei, WU Mei

2020, 28(12):  1382-1384.  DOI: 10.11852/zgetbjzz2020-0537

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Objective To analyze the audiological results of infants who failed in the hearing screening in Xinjiang, in order to provide scientific basis for early intervention. Methods A total of 350 neonates,who failed in the hearing screening and were referred to People′s Hospital of Xinjiang Uygur Autonomous Region,were enrolled in this study, and their Objective hearing was evaluated by auditory brainstem response, distortion product otoacoustic emissions and tympanometry. Results Among the 350 infants(700 ears), 104(29.71%) infants were with normal hearing, 75(21.43%) infants showed monaural hearing loss, and 171(48.86%) infants showed binaural hearing loss.There was no significant difference on the detection rate of hearing loss among different ethnic groups(χ²=0.362, P＞0.05).There were 130 ears with mild hearing loss (18.57%), 151 ears with moderate hearing loss (21.57%), 59 ears with severe hearing loss (8.43%), and 76 ears with very severe hearing loss (10.86%).The detection rate of negative peak tympanogram in infants with mild to moderate hearing loss was significantly higher than that in infants with severe and extremely severe hearing loss(χ²=55.878, P＜0.05).Moreover, 280 ears with identified with sensorineural hearing loss and 136 ears with conductive hearing loss. Conclusions Middle ear problem is an important influencing factor of failure in hearing screening of infants with mild and moderate hearing loss.The assessment of hearing loss in infants is a continuous process, requiring regular review and comprehensive assessment with multiple detection methods.

Risk factors and prognosis of mycoplasma pneumoniae pneumonia associated with inflammatory tracheostenosis in children

SHENG Jiang-yin, RUAN Gui-ying, YIN Yan-dan, HONG Yan, SU Qun-yan, NAN Xiang-zhen

2020, 28(12):  1385-1388.  DOI: 10.11852/zgetbjzz2020-0287

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Objective To investigate risk factors and prognosis of mycoplasma pneumoniae pneumonia (MPP) associated with inflammatory tracheostenosis in children,so as to provide reference of prevention and treatment in children′s MPP. Methods Clinical data of 116 children diagnosed with MPP and treated with bronchoscopy from January 2018 to January 2020 in Yuying Children′s Hospital Affiliated to Wenzhou Medial University were analyzed.According to the results of bronchoscopy,children were divided into the inflammatory tracheostenosis group (n=53) and the normal group (n=63).Clinical manifestations,laboratory and radiological results,and treatment outcome were compared between the two groups.Multiple Logistic regression analysis was used to analyze risk factors of MPP associated with inflammatory tracheostenosis in children. Results Compared with normal group,the levels of CRP(Z=3.368) and LDH(t=4.102),lobar pneumonia(χ²=20.496),fever duration(Z=2.151),cough duration day(χ²=2.527),hospitalization time(t=2.432),hospitalization expenses(Z=2.733) were significantly higher in the inflammatory tracheostenosis group(P＜0.05).LDH≥411 U/L(OR=8.922,95%CI:2.982-26.695),CRP≥22.9 mg/L(OR=4.857,95%CI:1.530-15.414)and lobar pneumonia(OR=4.857,95%CI:1.530-15.414)were risk factors for MPP in children with inflammatory tracheostenosis. Conclusions CRP≥22.9 mg/L,LDH≥411 U/L and lobar pneumonia can be the risk factors for MPP in children with inflammatory tracheostenosis.MPP Children associated with inflammatory tracheostenosis have poor clinical outcome and should be early treated by bronchoscopy.

Role of neutrophils gelatinase-associated lipid delivery protein, interleukin-33 and tumor necrosis factor-α in the early prediction of bronchopulmonary dysplasia in very premature infants

ZOU Qiao-qiao, WANG Hui-qin

2020, 28(12):  1389-1392.  DOI: 10.11852/zgetbjzz2020-0284

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Objective To explore the role of serum neutrophil gelatinase-associated carrier protein(NGAL), interleukin 33(IL-33), and tumor necrosis factor alpha(TNF-α) in the early prediction of bronchopulmonary dysplasia(BPD) in very preterm infants. Methods The very premature infants admitted in Maternal and Child Health Hospital of Anhui Medical University from March 2018 to September 2019 were enrolled in this study and were divided into BPD group and non-BPD group according to the diagnostic criteria.The serum levels of IL-33, TNF-α and NGAL on the 1st, 14th and 28th day after birth were tested for comparative analysis, and receiver operating characteristic(ROC) curves were prepared to obtain early predictive efficacy of various indicators. Results 1) A total of 66 very premature infants were included, of whom 25 cases(37.9%) were in the BPD group, including 15 cases of mild BPD, 8 cases of moderate BPD, and 2 cases of severe BPD.2) The serum levels of IL-33, TNF-α and NGAL in the BPD group at different time periods were significantly higher than those in the non-BPD group(P<0.05), and the expression levels of the three indicators gradually increased during 14 days after birth(P<0.05).3) Children in severe BPD group had significantly higher levels of serum IL-33 on the 14th days and 28th days after birth than those with mild to moderate BPD(F=8.220, 15.763, P<0.05).4) ROC curve showed that the areas under curve(AUC) of serum levels of NGAL, IL-33, TNF-α on the 1st and 14th day after birth were 0.768, 0.752, 0.760, 0.875, 0.978 and 0.975, respectively. Conclusions IL-33, NGAL, and TNF-α are all early predictors of BPD, with the highest prediction efficiency of NGAL level on the 1st day after birth, and highest prediction efficiency of IL-33 level on the 14th day.Moreover, IL-33 may also be used as an indicator to assess the severity of BPD.

Effects of vitamin A nutrition on T lymphocyte subsets, inflammatory mediators and prognosis in preschool children with asthma

XIONG Li, HU Xiu-ming

2020, 28(12):  1393-1397.  DOI: 10.11852/zgetbjzz2020-0904

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Objective To investigate the effect of vitamin A nutrition on T lymphocyte subsets, related cytokines and prognosis in preschool children with asthma, in order to provide theoretical evidence for the prevention and treatment of bronchial asthma. Methods A total of 120 preschool children with bronchial asthma admitted to Huangshi Maternal and Child Health Hospital of Edong Medical Group from June 2017 to June 2019 were enrolled in this study, and their clinical data were collected retrospectively.Meanwhile, 80 healthy school-age children in this hospital were selected as control group.According to the nutritional status of vitamin A during hospitalization, the case group was divided into three groups: vitamin A normal group, vitamin A marginal deficiency group and vitamin A deficiency group.The nutritional status of vitamin A was compared between the case group and the control group, and the pulmonary function, T lymphocyte subsets, related inflammatory mediators and prognosis were recorded before and after the intervention. Results The vitamin A level in the case group [(0.73±0.32) μmol/L] was significantly lower than that in the control group [(1.02±0.23) μ mol/L](t=5.957, P<0.05), and the vitamin A nutritional status of the case group was significantly worse than that of the control group(Z=4.865, P<0.05).After treatment, the levels of CD4+, CD4+/CD8+ in vitamin A deficiency group were lower than those in the other two groups, and CD8+ was higher than those in the other two groups(P<0.05).The levels of hs CRP, EOS and IL-6 in vitamin A deficiency group were significantly higher than those in the other two groups(P<0.05).The difference in clinical efficacy among the three groups was statistically significant(χ²=13.165, P<0.05), with the worst clinical efficacy in the vitamin A deficiency group(52.17%) and the highest in the normal vitamin A group(94.74%). Conclusions Vitamin A marginal deficiency or deficiency is more common in preschool children with bronchial asthma, which is not conducive to the improvement of children′s cellular immune function and inflammatory response, and has a negative impact on prognosis.Clinical monitoring of vitamin A should be strengthened, and vitamin A preparation is suggested to be supplemented appropriately to improve the prognosis of children.

Application and follow-up study on the whole-body movement combined withGesell Developmental Scale in 64 high-risk preterm infants

PING Dong-pei, XU Shu-ling

2020, 28(12):  1398-1400.  DOI: 10.11852/zgetbjzz2019-18921

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Objective To analyze the value of general movements(GMs) combined with Gesell Developmental Scale (GDS) in predicting the outcome of motor development in high-risk premature infants,so as to provide scientific basis for early screening of high-risk premature infants with dyskinesia. Methods A total of 64 high risk infants Women and Infants Hospital of Zhengzhou were enrolled in this study from November 2016 to November 2018.GMs assessment was performed at the stage of twisting and uneasy movement.Infants were followed-up to the age of 12 months,and the clinical diagnosis and GDS were used to determine the outcome of motor development.The value of GMs assessment in predicting the motor development outcome of high-risk preterm infants were caculated. Results Among 64 preterm high-risk infants,3(4.69%) cases were found with cerebral palsy,16(25.00%) cases were with motor development retardation,and 45(70.31%) cases were found with normal motor development.In terms of predicting abnormal results of motor development,the specificity of the restless movement stage and twisting stages was 97.78%,84.44%,respectively,and the sensitivity was 15.79%,52.63%,negative predictive value was 73.33%,80.85%,positive predictive value was 75.00%,58.82%.In terms of prediction of cerebral palsy,the highest specificity of the assessment was 96.72% in the stage of the restless movement and the stage of the CS movement. Conclusion GMs combined with GDS helps to predict the motor development outcome of preterm high-risk infants.

Influence of different inhalation strategies on the quality of life for infants with moderate bronchopulmonary dysplasia

WEI Xiang, SUN Da-quan, SHI Su-jie, ZHOU Shao-hong, ZHANG Shan-shan, LIU Chan, CHEN Su-hong, ZHAO Qian-ye

2020, 28(12):  1401-1404.  DOI: 10.11852/zgetbjzz2020-0948

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Objective To study the effect of different budesonide inhalation strategies on the quality of life of preterm infants with moderate bronchopulmonary dysplasia(BPD) within the corrected age of 12 months old after birth. Methods Infants with moderate BPD, who were discharged from Neonatal Intensive Care Unit(NICU) of Lianyungang Maternal and Child Healthcare Hospital Affiliated to Yangzhou University from September 1st, 2016 to September 1st, 2019, were enrolled in this study.All the infants were inhaled with 0.9% sodium chloride(2 ml) and budesonide(1 ml) for 1 month after discharge from hospital.According to the atomization inhalation strategy, infants were randomly divided into three groups: long-term inhalation group(n=11), on-demand inhalation group(n=10) and none-inhalation group(n=10).The effects of atomization inhalation strategy on respiratory tract infection symptoms such as wheezing and fever, frequency of upper respiratory tract infection, pneumonia, times of admission to PICU, and tidal pulmonary function at corrected age of 1 and 12 months were analyzed retrospectively. Results There were no significant differences in frequencies of wheezing, fever and pneumonia, the times of admission to PICU and wheezing after physical activity within one year among long-term inhalation group, on-demand inhalation group and none-inhalation group(P>0.05), but the frequency of upper respiratory tract infection in the long-term inhalation group was significantly reduced(P<0.05).At the correct gestational age of 12 months, there were no significant differences in the tidal volume(VT/kg), inspiratory/expiratory ratio(Ti/Te), ratio of TPEF and TE(TPTEF/TE) and mean exhaled expiratory flow in the period of 75% tidal volume(TEF75) among the three groups(P>0.05).Compared with on-demand inhalation group and non-inhalation group, the ratio of VPEF and VE(VPEF/VE) in the long-term inhalation group was significantly higher at the corrected gestational age of 12 months(F=36.36, P＜0.05).The VPEF/VE at corrected gestational age of 12 months significantly increased than that at corrected gestational age of 1 month in long-term inhalation group(P<0.05). Conclusion Long-term budesonide inhalation strategy reduces the frequency of upper respiratory tract infection and improve VPEF/VE in children with moderate BPD during corrected age of 12 months, but has limited protection against acute aggravation or worsening of respiratory symptoms.

Study on the correlation between the proportion of outpatient children with asthma and PM2.5 and temperature in Hangzhou

CHEN Bao-hai, LI Wei, SHEN Zheng, XIANG Wen-qing

2020, 28(12):  1405-1407.  DOI: 10.11852/zgetbjzz2020-0720

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Objective To study the epidemiological characteristics of asthma in outpatients in Hangzhou and its relationship with PM2.5 and temperature, so as to provide basis for clinical prevention and control. Methods The outpatient data of children with asthma in Children′s Hospital Affiliated to Zhejiang University School of Medicine from 2015 to 2019 and the daily weather information from 2015 to 2019 were retrospectively collected, and its correlation was analyzed. Results From 2015 to 2019, a total of 784137 children were diagnosed with asthma in this outpatient department.Children under 3 years old were the main population of asthma, accounting for 49.66%.And children under 7 years old accounted for 84.38%.The prevalence of asthma in autumn and winter was significantly higher than that in other seasons.The number of outpatients was positively related to PM2.5 concentration in children with asthma(r＝0.237,P<0.001), but was negatively correlated with daily maximum temperature(r＝-0.436),daily minimum temperature(r=-0.418),daily temperature difference(r=-0.433),daily mean temperature(r=-0.433)(P<0.001). Conclusions Preschool children have a higher incidence of asthma.Parents are supposed to pay close attention to physical condition of children in autumn and winter with lower temperature and higher PM2.5 so as to prevent the occurrence of severe asthma disease.

Effect of Duraphat on the prevention of dental caries in early childhood with cerebral palsy

JIN Fei-fei, YANG Qi-qi, ZENG Xiang-ping

2020, 28(12):  1408-1411.  DOI: 10.11852/zgetbjzz2020-0437

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Objective To evaluate the preventive effect of Duraphat on dental caries among children with cerebral palsy(CP) aged 3-5 years in Dezhou,so as to provide basis for prevention of primary tooth caries in children with cerebral palsy. Methods A total of 107 children with cerebral palsy aged 3-5 years were selected from 9 rehabilitation institutions for children with cerebral palsy in dezhou city from Januany 2018 to January 2020 and were randomly divided into 2 groups.Children with cerebral palsy in the test group (54 cases with 1 080 teeth) were treated with fluoride varnish once every six months,while the control group (53 cases with 1 060 teeth) was blank group.At the same time,oral hygiene instruction was conducted for the guardian semi-annually for 4 times.Then the effect of intervention was compared between the two groups. Results After two years,there was no significant difference in caries rate between the two groups (χ²=2.256,P>0.05).However,there were statistically significant differences in the the incidence of dental caries(7.41% vs. 20.75%), dmft(2.41±2.02 vs.3.47±2.35) and the incidence of anterior caries(7.41% vs. 12.89%) (χ²=3.953,t=-2.512,χ²=10.615,P<0.05). Conclusion The use of Duraphat can reduce the caries incidence rate and dmft increments of primary teeth in early childhood with cerebral palsy and is worthy to be used widely in Dezhou district.

Epidemiological and clinical characteristics analysis of adenovirus infection in 9 962 hospitalized children with acute respiratory tract infection

LI Quan-heng, HAO Xiao-jing, DONG Wei-ran, GAO Wen-jie, WANG Yan-yan, ZHANG Lei, LI Qing-tao, LIU Xiao-juan, ZHANG Li-jun, LI Jin-ying, AN Shu-hua, WANG Le

2020, 28(12):  1412-1415.  DOI: 10.11852/zgetbjzz2020-0585

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Objective To describe the characteristics of adenovirus infection in children with acute respiratory infection, so as to provide reference for the treatment and prevention of acute respiratory infection in children. Methods From December 2016 to December 2018, a total of 9 962 children with acute respiratory infection in Hebei Children′s Hospital were enrolled in this study.The pathogens including adenovirus were detected by RT-PCR in children′s nasopharyngeal secretions, and the detection rate and clinical characteristics of adenovirus were analyzed. Results The total detection rate of adenovirus was 4.78%(176/9 962), and there was no significant difference between male and female(P＞0.05).There was significant difference in detection rate among different age groups(χ²=160.042, P<0.001).The highest detection rate in 2016—2018 was in November.There was no significant difference in the composition ratio of adenovirus infection during the two years(P>0.05), and bronchopneumonia was the major diagnosis.The total mixed infection rate of respiratory tract infection caused by adenovirus was 61.76%(294/476), and there was a significant difference in the mixed infection rate of each diagnosis(χ²=31.398, P<0.001). Conclusions Adenovirus is a common pathogen of respiratory tract infection in children in local area of Hebei, with a peak in November, causing symptoms of whole respiratory tract.Bronchopneumonia is the first diagnosis in all age groups.Adenovirus infections have a high rate of co-infection, with a rising trend of co-infection as respiratory infections spread downward.

Clinical observation of family-based early environmental enrichment rehabilitation for 0- to 6-month-old infants at a higher risk for cerebral palsy

LI Xiao-lin, XU Tian-you

2020, 28(12):  1416-1418.  DOI: 10.11852/zgetbjzz2020-0840

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Objective To analyze the effects of family-based early environmental enrichment rehabilitation on Gross Motor Function Measure Scale(GMFM) and daily activity(ADL) for 0- to 6-month-old infants at high risk of cerebral palsy. Methods A total of 124 infants at higher risk for cerebral palsy who were followed up in Taizhou Women and Children′s Hospital from August 2015 to August 2018 were enrolled in this study, and were randomly divided into the control group and treatment group.The control group was given routine rehabilitation training, while the treatment group was given family-based early environmental enrichment rehabilitation guidance additionally, such as visual, auditory, tactile intervention and family posture management.GMFM and ADL scores of the two groups were evaluated in the first visit, 3 months and 6 months of intervention, respectively. Results There were no significant differences in age, gender, GMFM score and ADL score between the two groups at the time of initial diagnosis(P>0.05).After 3 months of intervention, the GMFM score(t=5.594, P<0.001) and ADL score(t=9.793, P<0.001) of the treatment group were higher than those of the control group.After 6 months of intervention, GMFM score(t=8.829, P<0.001) and ADL score(t=11.469, P<0.001) in the treatment group were higher than those in the control group.After 3 months of intervention, there was no significant difference in the total effective rate between the two groups(P>0.05).But the total effective rate of intervention group was significantly higher than that of control group after 6-month intervention(98.4% vs.80.6%, P<0.05). Conclusion Family-based early environmental enrichment rehabilitation is conducive to improving gross motor function and daily living ability of infants at high risk of cerebral palsy, and significantly improving the prognosis of high-risk infants with cerebral palsy.

Study on local normative reference values for thyroid volume in children aged 8 to 10 years in Shaanxi province

DUAN Gang, DAI Hong-xing, NIU Gang, HUA Ji-li, LI Shan-shan, GAO Xue-juan, ZHANG Qing-ping

2020, 28(12):  1419-1422.  DOI: 10.11852/zgetbjzz2020-0686

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Objective To master the distribution of thyroid volume and goiter of the children aged 8 to 10 years in Shaanxi province, in order to establish local reference range. Methods A total of 39 counties (cities, districts) were randomly selected from Shaanxi province in 2019.From each county, one primary school was randomly sampled from each selected town, which located in five different geographic directions: east, west, south, north and middle in each county.Finally, 42 non-boarding students aged 8-10 years were selected from each primary school, and their thyroids were examined by B-ultrasonography and random urine samples were tested. Results Totally 7 762 children aged 8 to 10 years were investigated.The median urinary iodine concentrations (MUIs) of children were 209.90 μg/L, and the iodine nutrition level of children was more than adequate condition.MUIs in each investigated area were above 100 μg/L, and the iodine nutritional status had been considered sufficient.The data of the thyroid volume (TVol) was abnormal distribution and the median of TVol was 2.68 ml.Children′s TVol was progressively increasing with age.But there was no significant difference on TVol between the male and the female children(Z＝0.62, P>0.05).The lowest median of TVol appeared in Hanzhong city (1.90 ml), while the highest was in Ankang city (4.30 ml).The upper limit of normal thyroid volume of children at the age of 8, 9 and 10 years old was 4.4, 4.8 ml and 5.7 ml, respectively. Conclusion There is difference between the results of this study and the Chinese national standard, which can provide reference for monitoring iodine deficiency disorder (IDD) in Shaanxi province and establishing local normative values of TVol for children aged 8 to 10 years.