Table of Content

10 February 2021, Volume 29 Issue 2

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Original Articles

Association between parental overweight or obesity and clustering of cardio-metabolic risk factors in children

LI Zi-lin, MA Chuan-wei, ZHAO Min, XI Bo

2021, 29(2):  120-123.  DOI: 10.11852/zgetbjzz2020-0571

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Objective To examine the association between parental overweight or obesity and clustering of cardio-metabolic risk factors in children, so as to provide scientific evidence for prevention and control of cardiovascular risk factors. Methods A convenient cluster sampling method was used to conduct a cross-sectional study from a primary school in Huantai county, Zibo city, Shandong.A total of 1 280 children aged 6-11 years with complete data on physical examinations, information from a questionnaire and blood biochemical variables were enrolled in this study.The correlation between parental overweight or obesity and clustering of cardio-metabolic risk factors in children was analyzed. Results The prevalence rates of overweight or obesity among either and both parents were 55.6% and 19.8%, respectively.The prevalence rates of abnormal metabolic indices (abdominal obesity and elevated blood pressure) and the clustering of abnormal metabolic indices were significantly different among parents with different weight status (P<0.05 or <0.001).Compared with children whose parents both had normal weight, those whose either mother or father was overweight or obese had higher risk for developing abdominal obesity(OR＝2.00) and one abnormal metabolic indices(OR＝1.47)(P<0.05 or <0.001).However, children whose parents both had overweight or obesity had much higher risk of developing abdominal obesity(OR＝3.08), elevated blood pressure(OR＝1.74) and abnormal metabolic indices(OR＝1.64-4.60) (P<0.05 or <0.001). Conclusion Parental overweight or obesity is associated with abdominal obesity, elevated blood pressure and clustering of abnormal metabolic indices in children, suggesting high-risk children whose parents had history of overweight and obesity should be prioritized for giving intervention.

Validation of a simplified height-specific blood pressure table for screening high blood pressure among children and adolescents in Suzhou

HU Jia, SHEN Hui, YIN Jie-yun

2021, 29(2):  124-128.  DOI: 10.11852/zgetbjzz2020-0462

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Objective To validate a Simplified Height Specific Blood Pressure (BP) Table for screening high blood pressure (HBP) among children and adolescents in Suzhou,in order to provide reference for making strategies for preventing childhood HBP. Methods A total of 6 972 children and adolescents aged 7 to 17 years were selected in this study by stratified cluster random sampling method from 2017 to 2018,and were asked to fill out questionnaires,meanwhile their height,weight and BP were measured.According to Chinese Blood Pressure Reference for Children and Adolescents aged 7-18 years (WS/T 610-2018) (hereafter referred to as "gold standard"),a simplified height specific BP table was developed.Validation of HBP and high normal BP (HNBP) was assessed. Results According to gold standard and simplified height specific BP table,the detection rates of HNBP in children and adolescents aged 7 to 17 years in Suzhou were 16.7% and 16.6%,respectively,and the detection rate of HBP was 12.7% and 12.8%.Paired chi-square test showed that there was no significant difference on the prevalence of HNBP and HBP identified by two standards (χ²=1.376,P=0.711).Performance of simplified height specific BP table was in good agreement with gold standard.When screening HNBP,the area under the curve (95%CI),sensitivity,specificity and Kappa value were 0.900(0.887-0.913),83.2%,96.8%,and 0.803,respectively.And corresponding values for screening HBP were 0.925(0.911-0.938),86.9%,98.0%,and 0.848,respectively. Conclusion Simplified height specific BP table is easy to use,and it shows satisfying effect for screening HNBP and HBP.

Analysis of nutritional anemia and its association with vitamin A in migrant children aged 6 to 35 months in Beijing

ZHANG Hai-feng, FENG Chao, ZHANG Ting, GUAN Hong-yan, CUI Ming-ming

2021, 29(2):  129-133.  DOI: 10.11852/zgetbjzz2020-0768

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Objective To explore the status and the influencing factors of nutritional anemia and its association with vitamin A (VA) in migrant children aged 6 to 35 months in Beijing, in order to provide a scientific basis for the effective preventive measures for nutritional anemia in migrant children. Methods By using the convenient cluster sampling method, a cross-sectional survey on 308 children aged 6 to 35 months was conducted in 2017 from the migrant population settlement areas of Chaoyang, Haidian and Changping District in Beijing. Hemoglobin and VA levels were measured. Results The prevalence rate of anemia was 27.92% among migrant children aged 6 to 35 months in Beijing, with 29.19% in boys and 26.53% in girls. There were statistically significant differences among children at different age groups and different regions (P<0.001). And the prevalence rate of anemia was found highest in infants aged 6 to 11 months (52.63%). Children who had formula milk, lean meat, animal liver food had lower risk for anemia significantly (P＜0.05 or <0.01). VA level in children with anemia was significantly lower than that in the control group(P<0.001). Multivariate Logistic regression analysis showed that the residence area, age and VA level were the influencing factors of nutritional anemia(P<0.05 or <0.01). Conclusions The prevalence of nutritional anemia is high among the migrant children aged 6 to 35 months in Beijing, especially in infants aged 6 to 11 months. Children with anemia have significantly lower levels of VA. It is suggested to strengthen the popularization of scientific feeding knowledge and to adjust the dietary structure reasonably among parents of migrant children.

Study on prefrontal cortical function in children with attention deficit hyperactivity disorder based on near-infrared spectroscopy

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

2021, 29(2):  134-137.  DOI: 10.11852/zgetbjzz2020-0485

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Objective To analyze the prefrontal cortex function of children with attention deficit hyperactivity disorder (ADHD) based on near-infrared spectroscopy imaging, so as to provide reference for the individual diagnosis and treatment of ADHD. Methods A total of 100 children who visited ADHD clinic and physical examination clinic of Shanghai Children's Hospital from July 2019 to February 2020 were selected.Parents filled in the ADHD assessment scale and demographic data, clinicians conducted comprehensive interviews and physical examination, and the therapist performed Webster intelligence test and prefrontal cortical function test based on near infrared spectroscopy. Results A total of 70 children were selected as effective samples after screening, including 35 children confirmed with ADHD, and 35 normal control children in the same period (with similar age and gender).The average age of the ADHD group and normal control group was (8.2±1.3) and (8.9±1.0) years old, respectively.The oxygen and hemoglobin concentration of the left prefrontal cortex in ADHD group and control group was -0.005±0.033 and 0.020±0.021, respectively, with significant difference (t=3.781, P<0.001).In children with ADHD, the activation of the left cerebral cortex was significantly lower than that of the right (t=2.272, P<0.05), and there were no significant difference on the level of prefrontal cortex among ADHD children in different gender and age groups (P>0.05).Significant difference was found on the function of the right prefrontal cortex in children with different subtypes of ADHD (F=7.138, P<0.01), indicating that ADHD children with hyperactivity and impulsivity may have right frontal cortical function compensation. Conclusions The left prefrontal cortex function is impaired in ADHD children.The function level of the prefrontal cortex has no obvious correlation with age and gender.

Nutritional status of children aged 6 to 24 months of four poorest counties in Liangshan prefecture,Sichuan province

XIAO Shu-yue, YAO Shi-yi, MA Zhong-hua, XIONG Mei, PENG Jing, XU Tao

2021, 29(2):  138-142.  DOI: 10.11852/zgetbjzz2020-0147

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Objective To understand the status of nutrition and feeding practices among children aged 6 to 24 months in four poorest counties in Liangshan prefecture,so as to provide evidence for developing interventions targeted on the promotion of child nutrition and health. Methods From April to July 2018,1 244 children aged 6 to 24 months in four poorest counties were selected by multi-stage random sampling for physical measurement,hemoglobin (Hb) test and caregiver interview. Results The prevalence rates of anemia,underweight and stunting were 51.9%,9.5% and 25.6%,respectively.Multifactor analysis results showed that child's gender,age,mother's education background,mother's occupation,whether the caregiver thinks "complementary feeding should be started at 3 months of age","cereal puree is the most suitable complementary food to add first","animal blood and red meat are the iron-rich foods" and "anemia is related to iron deficiency",whether the child has been breastfed,whether the child has been breastfed continuously after 6 months of age were the main factors associated with the nutritional status of children. Conclusions The nutrition of children aged 6 to 24 months in four poorest areas in Liangshan prefecture need to be improved urgently.Health promotion and education should be strengthened in order to improve caregivers' knowledge of child feeding,thereby promoting the benefit of Yingyangbao and correct inappropriate feeding practices.

Status and influential factors of vitamin A among children aged 0-6 years in the Tibetan Plateau of Ganzi Prefecture, Sichuan Province

HUANG Ping, LIN Xin-mei, GUO Du-ping, BA Xue-guo, WEI Zheng-rong, DING Hong-yan, HE Mao-yun, WANG Quan-sheng, XU Shi-ying, KE Gang

2021, 29(2):  143-146.  DOI: 10.11852/zgetbjzz2020-0676

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Objective To investigate the serum vitamin A (VitA) level of 0- to 6-year-old children in Ganzi Tibetan Autonomous Prefecture, so as to provide reference for the prevention of vitamin A related diseases. Methods Totally 2 122 Tibetan children were examined in Xiangcheng and Daocheng counties of Ganzi Prefecture from April 2017 to April 2019, and the content of serum VitA was detected by High Performance Liquid Chromatography. Results The average level of serum VitA in 2 122 children aged 0~6 years was (1.05±0.27)μmol/L.The subclinical deficiency rate was 8.15%, and the suspect subclinical deficiency rate was 45.99%.The average level of VitA in infant group was (0.94±0.26)μmol/L, significantly lower than that in toddlerhood group [(1.09±0.28)μmol/L] and preschool group [(1.05±0.27)μmol/L](F=15.308,P＜0.001).The average VitA level above 4 km was (0.96±0.19)μmol/L, significantly lower than that of 2-3 km [(0.99±0.26)μmol/L] and 3-4 km [(1.12±0.27)μmol/L](F=61.735,P＜0.001).The average level of VitA in summer was higher than that in other seasons(F=52.194,P＜0.001).In addition, the subclinical deficiency rate of 0-1 year old group was 23.97%,significantly higher than that of other age groups(χ² =43.503,P＜0.001).Logistic regression analysis showed that altitude, season and age all had an influence on subclinical deficiency and suspicious subclinical deficiency, and the incidence of subclinical deficiency and suspected subclinical deficiency increased with altitude. Conclusions The average level of VitA in children aged 0-6 years in Ganzi Tibetan Autonomous Prefecture is low, mainly with suspicious subclinical deficiency.The deficiency of VitA is related to age, altitude and season.Children at different ages are suggested to take VitA supplementation and food rich in VitA according to local altitude and season to prevent VitA deficiency and related diseases.

Growth and development of students in public and migrant schools in Gusu District,Suzhou City

DING Lei, CHEN Bin, XU Qin

2021, 29(2):  147-150.  DOI: 10.11852/zgetbjzz2020-0136

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Objective To compare the growth and development of students in public schools and migrant workers' schools,and to understand the differences between them,so as to provide scientific basis for health decisions. Methods A total of 6 441 students from 3 public schools and 3 870 students from 4 migrant children's schools in Gusu District of Suzhou City as the research objects.Data of 2018 physical examination were used to calculate the mean age and the average growth value per year,thus to fit the growth trend curve and growth rate curve of students at different age groups in the same period.Height,weight and nutritional status were analyzed and compared between the two groups. Results 1) The height and weight of male and female students in public schools and schools for migrant workers were increasing (P<0.001),and the peak age of the sudden increase except from girls was respectively consistent.The age-specific height,age-specific weight,and year-on-year growth peaks of students in migrant schools were lower than those in public schools.2) In migrant school,the height of boys and girls at the age of 8-12 years,the weight of boys aged 8-9 years and 11-12 years,as well as the weight of girls at the age of 11 years old were significantly lower than those in public schools (P<0.001).3) The detection rate of normal development in boys of migrant schools was higher than that of public schools (P<0.05),and the detection rates of overweight in boys and girls in public schools were higher than those of migrant schools (P<0.05). Conclusion The growth and development level of students in migrant schools is lower than that of public schools,so the attention from multiple departments is required.

Relationship between serum monoamine oxidase and obesity in children and adolescents

WANG Chun-qi, LIU Lei, LIU Yang, XU Zhi-yong, WANG Yi-nuo, ZHUANG Xu-xiu, WEN De-liang

2021, 29(2):  151-155.  DOI: 10.11852/zgetbjzz2020-0240

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Objective To explore the relationship between serum monoamine oxidase level and obesity in children and adolescents and its correlation with cardiovascular and metabolic indexes,so as to provide theoretical basis for prevention and treatment of obesity and its related complications. Methods Totally 1 007 middle school students from Shenyang city were enrolled in this study to perform physical examination from April to Norember 2018,including body measurements and serum biochemical tests.And the results were analyzed according to different levels of obesity group. Results The rate of obesity was 14.40%,which was significantly higher in boys (16.33%) than girls (12.48%).One-way ANOVA showed that of the serum monoamine oxidase level of the obese group was higher than that of the normal by 16.32%[(8.48±2.10) U/L for obese group and (7.29±3.02) U/L for normal group,F=9.874,P＜0.001].Logistic regression analysis showed that the increase of serum monoamine oxidase was a risk factor for obesity(OR=1.13,95%CI:1.06-1.20,P＜0.001).Linear correlation and regression analysis showed that the serum monoamine oxidase level was correlated with body mass index(β=0.083,95%CI:0.025-0.140,P=0.005) and AST level (β=0.039,95%CI:0.003-0.075,P=0.032). Conclusion Serum monoamine oxidase might be involved in some physiological processes related to obesity such as fat metabolism and sugar metabolism,so that the increase of serum monoamine oxidase is a risk factor for obesity.

Effect of infant growth on adolescent sexual development

WAN Bin, HE Miao, GUO Chun-yan, ZHAN Hai-rong

2021, 29(2):  156-159.  DOI: 10.11852/zgetbjzz2019-1833

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Objective To explore the effect of rapid growth in infancy on puberty sexual development, in order to provide reference for preventing early puberty in the future. Methods From January 2004 to January 2005, 198 infants who grew too fast were selected as the observation group and 175 normal infants were selected as the control group from Wenzhou Children's Hospital and Shiyan People's Hospital. According to the time point of menarche/ spermatorrhea, the observation group was divided into precocious puberty group and normal development group. Spearman correlation analysis was used to analyze the correlation between height Δvalue, weight Δvalue and puberty precocious puberty in the observation group. Results The height Δvalue and weight Δvalue of one-year-old infants in the observation group were significantly higher than those in the control group (t=2.085,2.146,P<0.05). The height, weight, body fat and bone age of children in the observation group were significantly higher than those in the control group, and the levels of testosterone(T), estradiol(E2), follicle stimulating hormone(FSH) and luteinizing hormone(LH) in the observation group were significantly higher than those in the control group (P<0.05). There were no sexual precocious children in the control group. There was no significant difference in gender among the precocious group,the normal group and the observation group (P>0.05). The height, weight, body fat and bone age of the precocious group were significantly higher than those of the normal group, and the levels of T, E2, FSH and LH in the precocious group were significantly higher than those in the normal group (P<0.05).There was a positive correlation between the height Δvalue and the weight Δvalue of one year old infants in the observation group and puberty precocious puberty (r=0.816, 0.872, P<0.001). Conclusions Rapid growth in infancy can lead to pre-puberty obesity and excessive body fat, and early puberty. It is of great significance to control the overgrowth during infancy for the prevention of early puberty in the future.

Review

Research advance in unconventional regulation of small non-coding RNAs in obesity

XIE Han-ying, WANG Xing-yun, WANG Jun, HAN Shu-ping, CHEN Xiao-hui

2021, 29(2):  160-164.  DOI: 10.11852/zgetbjzz2019-1880

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Obesity is a chronic metabolic disorder disease characterized by excessive fat accumulation,causing heavy burden to the health.In general,small non-coding RNAs (miRNAs) negatively regulate protein-coding gene expression at post-transcriptional level through being incorporated in RNA-induced silencing complex,which play an important role in the development of obesity.Recent studies suggest that miRNAs also can function in an unconventional manner,including interacting with the 5'untranslated region of messenger RNAs (mRNAs) and enhancing their translation,indirectly regulating mRNAs in transcriptional level,targeting on non-coding RNAs (ncRNAs),regulating mitochondrial gene translation,encoding peptides and serving as ligands for Toll-like receptors.The discovery of these unconventional roles of miRNAs opens a new promising field of miRNAs research.In this review,recent literatures on these unconventional roles of miRNAs and the mechanisms associated with obesity are summarized.

Research progress on exercise improving brain reward function and preventing obesity in children and adolescents

LI Juan, WANG Hai-jun, CHEN Wei

2021, 29(2):  165-168.  DOI: 10.11852/zgetbjzz2019-1285

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Abnormal reward function is closely related to the occurrence of obesity.Exercise can improve hedonic overeating and increase physical activity by adjusting the reward system function,which has a positive influence on the prevention and treatment of obesity in children and adolescents.During this process,the plasticity of dopaminergic pathway projected from the midbrain to striatum plays an important role.This paper summarizes the current research situation in this field in order to provide a new theoretical perspective for the prevention and control of obesity in children and adolescents.

Early risk factors for childhood obesity

CHEN Xiao-zheng, LI Yi-chen

2021, 29(2):  169-172.  DOI: 10.11852/zgetbjzz2020-0242

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Over the past decades,the number of children with obesity has increased significantly.Obesity not only affects physical and mental health of children,but also increases the risk of metabolic syndrome in adulthood.The main risk factors for childhood obesity include being overweight or obesity before pregnancy,excessive gestational weight gain,gestational diabetes or hypertension,cesarean section,macrosomia,artificial feeding and lack of physical activity,etc.This review aims to summarize the risk factors increasing risk of childhood obesity from pre-pregnancy to 2 years old,thereby providing suggestions for the prevention of obesity in early childhood.

Progress on the application of individualized human milk fortification in the growth and development of preterm infants

TAN Ji-lei, WEI Qin, HUANG Xiao-bo, FENG Zhao-yan, SONG Jing-wen

2021, 29(2):  173-175.  DOI: 10.11852/zgetbjzz2019-1883

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With the rapid development of neonatal critical care medicine,the survival rate of preterm infants has significantly improved,and their life quality is gradually concerned.Nutrition during hospitalization is one of the key determinants of short-term and long-term quality of life in preterm infants.And it's reported that the implementation of individualized human milk fortification during hospitalization can not only optimize nutrition,but also promote the best growth patterns.Therefore,this article reviews the individualized human milk fortification of preterm infants,in order to provide references for clinical work.

Research advances on the effects of electronic screen exposure on sleep in children

LIU Ming-xia, HUA Jing

2021, 29(2):  176-180.  DOI: 10.11852/zgetbjzz2020-0378

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As an important indicator and influencing factor of children's physical and mental state, sleep plays a crucial role in children's healthy development.With electronic screen becoming one of the main sources of information spread in daily life, there are constant reports of possible effects of excessive screen exposure on sleep during childhood.This study reviewed the specific effects and mechanisms of electronic screen exposure on sleep in children, summarized relevant principles and intervention methods, thereby identifying and intervening the sleep problems related to electronic screen exposure earlier, and providing clues for further clinical and basic researches on the effects of electronic screen on sleep in Chinese children.

Meta Analysis

Visual analysis of the researches on precocious puberties

NIU Jin-bo, LIU Chong, MA Wei-feng, ZHU Jun-xia

2021, 29(2):  181-185.  DOI: 10.11852/zgetbjzz2020-0705

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Objective To investigate the research status, hotspots and frontiers of the international researches on precocious puberties, so as to provide ideas for the development of related research in China. Methods Using bibliometric method, relevant journals and review papers from 2010 to 2020 were searched from Web of Science database.By analysis and retrieval results of ISI Web of Knowledge and its function of creating citation report, CiteSpace 5.0.R1SE software was used to draw knowledge map.Quantitative statistics and qualitative analysis were conducted to summarize the research volume, citation number, main research countries/areas, main research institutions, cited reference, research hotspots and research frontiers in this field. Results A total of 1 966 related literatures were retrieved, and the number of global published literatures in this field increased rapidly from 2010 to 2020.The dominant nations included America, China because of their large number of publications.Institutions involved University of Sao Paulo,Harvard Medical School most, and the category involved genetics, psychology, environmental sciences and public health.The research hotspots contained mutation, analog treatment over the past several years. Conclusions With the increasing attention of researchers from all over the world, gene diagnosis and new treatment methods have become the focus of research.But there is still a gap on the current research level in this field between China and abroad.It is required that Chinese scholars should strengthen exchanges and cooperation with international experts while doing the basic work.

Clinical Research

Investigation on the relationship between language development and screen exposure in children aged 1 to 3 years in community

XIAO Dan-xia, LI Hong

2021, 29(2):  186-189.  DOI: 10.11852/zgetbjzz2020-0220

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Objective To analyze the correlation between language development and screen exposure in children aged 1-3 years in community, so as to provide suggestions for improving the current situation of screen exposure in children. Methods A total of 827 children aged 1-3 years born in Zhujiang Hospital of Southern Medical University from January 2016 to July 2018 were enrolled in this study, including 406 boys and 421 girls with average age of (24.5±5.3) months old.Clinicians in Department of Pediatric Neurorehabilitation asked the subjects' medical history in detail, carried out physical examination and behavior observation, and evaluated the language development by Gesell Infant Development Scale and the Early Language Development Process Scale. Results Among 827 children, 93 were diagnosed with language retardation and 734 were normal.There were significant difference on contacting screen age, children's sex, family situation, parental education level, maternal age, screen exposure time, regular sleep habits, contacting screen accompanied by parents and limiting screen exposure time between language retardation group and normal group (P<0.05).After controlling confounding factors, Logistic regression analysis showed that screen exposure time >2 hours (OR=1.687, 95%CI:1.022—2.236, P<0.001), contacting screen not accompanied by parent (OR =2.035, 95%CI:1.588—2.634, P=0.002) and no limit of screen exposure time (OR=1.475, 95%CI:1.087—2.156, P=0.035) were risk factors for language retardation. Conclusions Long-term screen exposure will affect the family language environment and children's sleep, and is not conducive to children's language development.Parents are advised to forbid children under 18 months old from screen exposure, and children over 18 months old are not allowed to touch the screen until accompanied by their parents.Moreover, screen time should be controlled within 2 hours, and watching the electronic screen before going to bed should be strictly avoided.

Correlation analysis of pulmonary function and serum 25-hydroxyvitamin D level in school-aged obese children

QIAN Yi, SUN Hui-hui, LIN Hong-rui, ZHANG Jin, ZHANG Tian, WAN Nai-jun

2021, 29(2):  190-193.  DOI: 10.11852/zgetbjzz2020-0572

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Objective To analyze the characteristics of pulmonary ventilation function in school-age obese children and its correlation with serum 25-hydroxyvitamin D [25-(OH)D], and to explore the mechanism of the effect of vitamin D on the pulmonary function of obese children. Methods Totally 104 obese children aged 6-12 years were recruited from January 2019 to January 2020 to measure their height, body mass, serum 25-(OH)D level and pulmonary ventilation function.Pulmonary ventilation function parameters were compared in obese children with deficient, insufficient and appropriate serum vitamin D level.Multiple linear regression was used to analyze the correlation between serum vitamin D and pulmonary function parameters. Results The lung function parameters in mild to moderate obesity group were higher than those in severe obesity group, and the differences in FEF50% and MMEF between the two groups was significant (t=2.808,2.164, P<0.05).The difference in FEV1, FVC, PEF, FEF25%, FEF50% and FEF75% were significant among obese children with deficient, insufficient and appropriate serum vitamin D level(F=3.988, 4.758, 3.142, 5.186, 3.478, 3.220, P<0.05).Multiple linear regression showed that pulmonary function parameters FEV1, FVC, PEF, FEF25%, FEF50%, FEF75% and MMEF were positively linear correlated with serum 25-(OH)D level (B=0.341, 0.315, 0.371, 0.745, 0.665, 0.715, 0.613, P<0.05).Significant correlation was not found between FEV1/FVC, FEV1/FVC% and serum 25-(OH)D level. Conclusion There is a linear positive correlation between serum 25-(OH)D level and some lung function parameters of school-age obese children, which may be a protective factor of lung function of obese children.

Analysis of serum 25-hydroxy vitamin-D level and children's growth pain and other related factors

LI Xue-feng

2021, 29(2):  194-197.  DOI: 10.11852/zgetbjzz2019-1297

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Objective To investigate the serum 25-hydroxy vitamin D[25-(OH)D] level and other related factors of children's growth pain (growing pain,GP). Methods From December 2015 to June 2019,121 children with GP inDaxing District Maternal and Child Health Hospital were treated as the observation group,and 121 healthy children who came to our hospital for physical examination during the period were selected as the control group.Observation group was given comprehensive treatment such as vitamin D supplementation to observe the curative effect and compare the changes of serum 25-(OH)D,blood calcium,blood phosphorus and bone mineral density of children before and after treatment.Univariate and multivariate analysis of other risk factors for GP may occur. Results A total of 105 cases were effective,the effective rate was 86.78%; 25-(OH)D was significantly higher than before treatment (P<0.01),close to the control group,no statistical significance compared with the control group (P>0.05); Blood calcium and blood phosphorus levels before and after treatment compared with ultrasound bone mineral density,the difference was not statistically significant (P>0.05),and compared with the control group was not statistically significant (P>0.05); Logistic regression test showed that family history(OR＝2.116,95%CI:1.653~2.879),physical activity time>2 h/d(OR＝1.279,95%CI:1.038~1.508),and picky eating (OR＝2.745,95%CI:1.348~5.607)were all risk factors for GP. Conclusions Children's GP may be related to 25-(OH)D levels.Vitamin D has a significant therapeutic effect on GP(P<0.05 or <0.01).The children's bone nutritional status is evaluated and effective treatments are formulated.

Analysis of nutritional diseases of children under 5 years old in Lanzhou from 2000 to 2018

ZHENG Rong, LIANG Fang, BAI Jin, PAN Li, BAI Qing-li, LI Zhi-lan

2021, 29(2):  198-201.  DOI: 10.11852/zgetbjzz2020-0465

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Objective To analyze the prevalence of nutritional diseases in children under 5 years old in Lanzhou from 2000 to 2018, and to explore the possible influencing factors. Methods Data of maternal and child health annual report in Lanzhou from 2000 to 2018 were collected, and the results were described by dynamic series through Chi-square and trend Chi-square test and Spearman correlation test with SPSS 20.0 software. Results From 2000 to 2018, the prevalence of moderate and severe malnutrition in children under 5 years old in Lanzhou was 2.57%, showing a downward trend (χ²_trend=159.200, P<0.05).There was no significant difference between urban areas and counties (χ²=0.205, P > 0.05).The low weight rate (1.65%), growth retardation rate (0.69%), overweight rate (2.21%) and obesity rate (0.05%) of children under 5 years old in Lanzhou showed a downward trend from 2014 to 2018(P<0.05).Neonatal visit, healthcare coverage for children under 7 years old, systematic management for children under 3 years old, breastfeeding within 6 months old and exclusive breastfeeding within 6 months old were all negatively correlated with the occurrence of moderate and severe malnutrition in children under 5 years old (r=-0.712,-0.663,-0.784,-0.750,-0.909,P<0.05). Conclusions The rate of moderate and severe malnutrition of children under 5 years old in Lanzhou is decreasing, and the gap between cities and counties is gradually narrowing.At present, there is a double burden of overweight and obesity in urban children and low weight growth retardation in suburban children in Lanzhou, but the prevalence is at a low level in the whole country.Thus it is supposed to strengthen children's health care, actively carry out health education and promote children's healthy growth.

Relationship between 25-hydroxyvitamin D deficiency and anemia in infants aged 0 to 3 years in Nanjing

JIANG Jia-hong, LI Jie

2021, 29(2):  202-204.  DOI: 10.11852/zgetbjzz2020-0522

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Objective To analyze the level of 25 hydroxyvitamin D[25-(OH)D] in infants aged 0-3 years in Nanjing, and to explore its correlation with anemia. Methods A total of 1 143 children aged 0-3 years old who underwent routine physical examination in the children health clinic of women and children's branch of Jiangsu Province Hospital from August 2017 to October 2019 were enrolled in this study.The levels of 25-(OH)D and hemoglobin (Hb) of peripheral blood were tested and the correlation between the level of 25-(OH)D and Hb in different age groups was analyzed. Results The average level of 25-(OH)D was (79.03±25.71) nmol/L in 1 143 infants aged 0~3 years, among whom 113 (9.88%) were deficient, 451 (39.46%) were insufficient, and 579 (50.66%) were adequate.The difference on 25-(OH)D level in different age groups was significant (F=25.26, P<0.01), with the lowest level in the 2 to 3 years old group.122 cases (10.67%) suffered from anemia, and 1 021 cases (89.33%) were non-anaemic.The detection rate of anemia in 25-(OH)D deficiency group was significantly higher than that in adequate group (χ² =8.261, P=0.004).Pearson correlation analysis showed that there was a positive correlation between the level of 25-(OH)D and Hb in the groups of 0 to 0.5 year old, 0.5 to 1 year old, and 1 to 2 years old (r=0.288,0.274,0.123, P<0.05), while no correlation was found in the group of 2 to 3 years old (r=0.080,P=0.264). Conclusions The overall rate of 25-(OH)D deficiency and insufficiency is relatively high in infants aged 0 to 3 years in Nanjing.And there is a positive correlation between the level of 25-(OH)D and Hb in infants aged 0 to 2 years, suggesting that the lack of 25-(OH)D may affect the generation of Hb and be related to the occurrence of anemia in infants.

Analysis of the relationship between the expression of TLRs signaling pathway and inflammatory factors and recurrent respiratory tract infection

WU Shao-hui, HUANG Xiao-dong, XU Zhi-hang

2021, 29(2):  205-208.  DOI: 10.11852/zgetbjzz2020-0897

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Objective To study the relationship between Toll like receptor (TLRs) signaling pathway and expression of inflammatory factors and recurrent respiratory tract infection, in order to provide monitoring targets for clinical treatment. Methods A total of 150 children with recurrent respiratory tract infection treated in the Second People's Hospital of Longhu District from January to December 2019 were included in this study and were selected as case group. Meanwhile, 150 healthy children who took physical examination were selected as control group. Then the levels of TLRs signaling pathway, inflammatory related factors and oxidative stress related indexes were compared between the two groups. Results The levels of Toll like receptor 2 (TLR2) and TLR4 in the case group were significantly higher than those in the control group(t=69.981, 101.427, P＜0.001). Additionally, the levels of serum interleukin-4 (IL-4),interleukin-10(IL-10) and interferon gamma (INF-γ) in the case group were significantly higher than those in control group(t=78.453, 63.388, 116.697, P＜0.001), while the level of tumor necrosis factor-α (TNF-α) was significantly lower in the case group(t=70.489, P＜0.001). Pearson correlation analysis showed that the TLR2 and TLR4 levels were positively related to the levels of IL-4, IL-10 and TNF-α, but negatively correlated with INF-γ levels(P＜0.05). The differences on superoxide dismutase(SOD), malondialdehyde(MDA) and catalase(CAT) between the case group and control group were significant(t=28.633, 57.277, 50.103, P＜0.001). Conclusion The TLRs signaling pathway and inflammatory factors may be involved in the occurrence and development of recurrent respiratory tract infection, and children with recurrent respiratory tract infection apparently have abnormal oxidative stress.

Epidemiologic survey of growth and development as well as anemia among 2- to 6-year-old children registered in kindergartens in Lasa

CIDAN Wang-mu, ZHENG Xiao-ling, LIU Zhi-juan

2021, 29(2):  209-213.  DOI: 10.11852/zgetbjzz2020-0272

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Objective To understand the growth and development, and anemia among 2- to 6-year-old children registered in kindergartens in Lasa, so as to provide scientific reference for making health promotion policies. Methods Totally 1 995 children aged 2 to 6 years, who went to health examination for kindergarten entrance in 2018 in Maternal and Child Health Care Hospital of Tibet Autonomous Region, were enrolled in this study.Children's height, weight, hemoglobin and serum iron were measured. Results Among 1 995 children, 1 016(50.93%) were boys.Most children were 3 years old (1 439, 72.13%), and Tibetan (1 766, 88.52%).The overall prevalence rates of underweight, stunting, wasting and anemia were 22.06%, 8.37%, 1.45% and 68.57%, respectively.The prevalence of underweight increased with age ( χ²_trend=53.42, P<0.001).The prevalence of underweight was 34.84%.Tibetan children had a lower prevalence rate of underweight than non-Tibetan children (21.18% vs 28.82%, χ²=6.89,P<0.01).The prevalence of anemia among different age groups were significantly different (χ²=33.10, P<0.001).The prevalence of anemia was highest (69.28%) among 3-year-old children.Tibetan children had a higher anemia prevalence than non-Tibetan children (71.07% vs.49.34%, χ²=49.95, P<0.001). Conclusions The overall prevalence of underweight, stunting, wasting and anemia are relatively high, and the growth and development is suboptimal.It is suggested to give targeted health education about appropriate feeding taking consideration of local Tibetan food culture.Moreover, food rich in iron or helpful to promote iron absorption should be especially encouraged.

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Height distribution of children aged 3 to 14 years in Xichang City

ZHANG Yue, SHI Yan, BIAN Cheng-peng, WANG Qin, CHEN Xue, ZHANG Fan

2021, 29(2):  214-217.  DOI: 10.11852/zgetbjzz2020-0219

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Objective To explore the characteristics of children's height in Xichang City, thus to provide basis for local children's health development. Methods A stratified cluster sampling method was used to select children aged 3 to 14 years in 19 schools in Xichang City from April to May in 2018.According to the requirements of "Chinese Children's Growth Standards and Growth Curves", children's height was uniformly measured, and data analysis was performed using SPSS 22.0 software. Results Among children in Xichang City, the height of Han boys aged 3-6 and 9-11, Yi boys aged 3-7 and 10-11, Han girls aged 3-7 and 9-10, Yi girls aged 3-10 were higher than those of the national standard(P<0.05).The height of Han boys in preschool age was higher than that of Yi boys (P<0.05).There was no difference on the height between Yi and Han children in school age and adolescence (P>0.05).But the height of boys was significantly higher than that of girls at all ages (P<0.05). Conclusions The height of children in Xichang City is generally higher than the national standard.Parents should pay attention to the role of height in children's growth and development.

Relationship between overweight and bone mineral density in infants aged 0 to 3 months in Beijing

ZHANG Qian, WAN Nai-jun

2021, 29(2):  218-221.  DOI: 10.11852/zgetbjzz2020-0261

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Objective To study the relationship between bone mineral density (BMD) and overweight infant of 0-3 months, so as to provide guidance for the health care of bone development in infancy. Methods Infants aged 0-3 months who took physical examination were investigated from January 2019 to January 2020.Because of the difference on the standards for body length, weight, speed of sound (SOS) between boys and girls, the research objectives of different genders were compared seperately.According to the 2006 WHO Child Growth Standards, research objectives were divided into overweight group and normal group.The level of BMD between overweight group and normal group was compared.Then, the BMD level was compared between different genders in each group. Results There were no significant differences on the level of SOS between overweight group and normal group in boys and girls (P＞0.05).Z value did not showed significant differences between boys and girls in overweight group and normal group (t=-1.23, -0.47,P＞0.05). Conclusions No significant correlation has been found between overweight and BMD in 0 to 3-month-old children.However, further studies are warranted to explore the relationship between various influencing factors and BMD or between aging and BMD, thereby providing better guidance for clinical practice.

Clinical analysis of 139 cases of infantile cow's milk protein allergy

ZHANG Wei, GUO Hong-wei, LIU Xiang-zeng, ZHANG Wei, LIN Yan, WANG Chun-hui, ZHANG Ni-ni, LI Tang, HUANG Jun-jie, LAN Li, JIANG Xun, WANG Bao-xi

2021, 29(2):  222-225.  DOI: 10.11852/zgetbjzz2020-0321

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Objective To analyze the clinical characteristics and therapeutic effect of cow's milk protein allergy(CMPA) in infants, in order to improve the clinical diagnosis and treatment of CMPA. Methods A total of 139 infants with CMPA in Tangdu Hospital of Air Force Military Medical University were enrolled in this study from January 2018 to December 2019, and their clinical manifestations and therapeutic effects were analyzed. Results 1) Among these 139 cases of CMPA, there were 98 cases with gastrointestinal tract symptoms, 80 cases with skin symptoms, 21 cases with respiratory symptoms, 10 cases with anemia and 24 cases with restlessness.2) The total effective rates of treatment for 4 weeks and 8 weeks in 138 CMPA cases were 68.3% and 81.3%, respectively.31 cases were treated with probiotics for 8 weeks, the total effective rate of probiotic group and control group was 90.3% and 78.3%,respectively, the difference was not significant(χ²=2.219,P=0.136).However, infants in probiotic group had showed significant improvement in symptoms of vomiting, antifeedant, bloody stool and eczema(P＜0.05), while significant improvements were only seen in vomiting and eczema in control group (P＜0.05). Conclusions The clinical manifestations of CMPA are diverse.Clinical diagnosis and treatment should be based on the condition of children.Besides, extensively hydrolysed formula(eHF) remains the recommended and preferred therapeutic choice, and amino acid formula(AAF) is reserved for the severe cases.The supplementation of probiotics during treatment may be helpful for elimination of the symptoms, and further studies are warranted.

Study on the associated factors of anterior fontanelle delayed closure in infants and children under 3 years old

CHEN Die, LI Xuan, TANG Meng-yan, LI Jin-rong

2021, 29(2):  226-229.  DOI: 10.11852/zgetbjzz2020-0043

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Objective To explore the associated factors of anterior fontanelle delayed closure (AFDC) in infants and children under 3 years old,so as to provide evidence-based reference for diagnosis and treatment of delayed closure of AFDC. Methods Totally 61 infants with AFDC born from January 1st,2015 to December 31st,2015 and 183 infants with normal anterior fontanelle closure followed up for three years were enrolled in this study,variables such as birth weight,birth length,the size of anterior fontanelle at 1 month old,gender,mode of delivery,gestational age,fetus number,parity,the birth order,VA and VD average supplementation before two years old,the onset for adding complementary foods were compared between the two group. Results Univariate analysis showed that birth weight(χ²=8.309,P=0.016),the size of the anterior fontanelle at 1 month old (Z=-4.065,P＜0.001),VA average supplement before two years old (Z=-2.072,P=0.038) were associated with delayed anterior fontanelle closure in infants.Logistic regression showed the larger size of the anterior fontanelle at 1 month old (B=1.260,OR=3.526,P<0.001) was the main associated factors of delayed anterior fontanelle closure in infants,while perinatal and nutritional factors had no significant effect on the delayed closure of anterior fontanelle. Conclusions Delayed closure of anterior fontanelle is related to congenital enlargement of anterior fontanelle,and may be related to the nutritional status.But maternal perinatal status has no significant influence on the delayed closure of anterior fontanelle.