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    10 September 2021, Volume 29 Issue 9
    Professional Forum
    Emotional/behavioral problems and social function problems of common developmental disorder in children
    HAO Yan
    2021, 29(9):  927-931.  DOI: 10.11852/zgetbjzz2021-0849
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    Neurodevelopmental disorders such as autism spectrum disorder(ASD),attention deficit/hyperactivity disorder(ADHD)and language disorder(LD)are common developmental disorders in children,often accompanied by mental behaviors and social function problems.Early identification,diagnosis and early targeted intervention measures are of great significance to improve their prognosis.This article introduces the emotional/behavioral problems and social functions of common developmental abnormalities in children for the reference of related professionals.
    Original Articles
    Research on restrictive interest of high-risk children with autism spectrum disorder based on eye tracking technology
    SUN Bin-bin, WANG Xin-yuan, WEI Zhen, FENG Zhe, ZHANG Shi, WAN Guo-bin
    2021, 29(9):  932-936.  DOI: 10.11852/zgetbjzz2021-0720
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    Objective To analyze the correlation between the characteristics of limited interest eye tracking and behavioral indicators of children with high-risk autism spectrum disorder(HR-ASD),so as to provide basis for early identification and intervention of subtypes of ASD. Methods From June 2018 to June 2020,children matched by age who met the criteria were enrolled in this study from Shenzhen Maternal & Child Health Care Hospital Affiliated to Southern Medical University,including 39 ASD children,49 HR-ASD children and 44 typical developed children.SMI RED250 portable eye tracking,Autism Observation Scale(ADOS)and Gesell development scale(GDS)were used to test the children.The results of eye tracking characteristics and behavioral indicators of the three groups were compared,and their correlation was analyzed. Results 1)For children in ASD group and HR-ASD group,the objects of interest for the first fixation were ships and table lamps,and the fixation track was irregular.While in typical developed children,the objects of interest for the first fixation were balloons,and the fixation track was regular.2)Children in ASD group and HR-ASD group had similar interest tendency,and the difference was statistically significant(F=123.01,89.32,P<0.01).Compared with typical developed children,children in ASD group and HR-ASD group had poor adaptability,fine motor,language and personal social skills(F=47.05,23.70,32.30,50.19,P<0.01).But there was no significant difference in general behavioral ability between ASD children and HR-ASD children(P>0.05).3)The eye tracking fixation time of ASD children and HR-ASD children was negatively correlated with language ability(r=-0.22,-0.43,P<0.05).The language ability of typical developed children was negatively correlated with their fixation on motor cars and swivel chairs(r=-0.17,-0.17,P<0.05),and their social interaction was positively related to their fixation on cakes(r=0.43,P<0.05). Conclusion Early recognition of the limited interest in high-risk ASD children is of great significance for early subtype classification,early auxiliary diagnosis and intervention of ASD.
    Associations between breastfeeding and neurodevelopment in infants
    CHEN Jia-jie, LIN Li-zi, HUANG Sai-jun, WANG Xin, GUO Cui-hua, WU Ning, JING Jin, CAO Mu-qing
    2021, 29(9):  937-941.  DOI: 10.11852/zgetbjzz2021-0921
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    Objective To investigate the associations between breastfeeding and neurodevelopment in infants,so as to provide evidence for improving breastfeeding rate. Methods Infants who took regular physical examination from two maternal and child health centers in Guangdong from August to December 2016 were enrolled in this study. Children's basic information and feeding patterns were obtained via questionnaire. Ages and Stages Questionnaire(ASQ) was used to evaluate infants' neurodevelopment. Multiple linear regression and Logistic regression were used to analyze the associations between feeding patterns and neurodevelopment of the included infants. Results Totally 245 infants were included,41.6% of whom was breastfed. The abnormal rate of communication domain was the highest(46.5%) and the gross motor domain was the lowest(16.3%) among all neurodevelopmental domains. After adjusted for potential confounding,children with formula feeding scored lower in communication domain and person-social domain(β=-11.18,95%CI:-18.13 to -4.22,P<0.001; β=-7.61,95%CI:-12.59 to -2.64,P<0.001),and scored higher in social-emotional domain(β=17.78,95%CI: 4.88-30.69,P=0.01) when compared with those of breastfeeding. Formula feeding was a risk factor for delayed development of person-social domain(OR=3.24,95%CI:1.19-9.10,P=0.02) and social-emotional domain(OR=3.39,95%CI:1.34-8.94,P=0.01). Conclusion Breastfeeding,one of the protective factors,is important for the development of person-social and social-emotional domains during infancy.
    Effect of pivotal response treatment training on children with autism spectrum disorders
    SONG Chun-lan, YAO Mei-ling, DUAN Gui-qin, XU Hai-ping, WANG Xiao-fang, LIU Qiu-yun
    2021, 29(9):  942-945.  DOI: 10.11852/zgetbjzz2020-1915
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    Objective To explore the clinical effect of pivotal response treatment(PRT) in children with autism spectrum disorder(ASD),so as to provide reference for the rehabilitation treatment of ASD children. Methods Totally 46 children aged 2—5 years who were diagnosed with ASD in the Third Affiliated Hospital of Zhengzhou University from January 2019 to December 2019 were enrolled in the study and were randomly divided into conventional group(n=23) and PRT group(n=23). Both groups were assessed by the Autism Behavior Checklist(ABC),Childhood Autism Rating Scale(CARS) before intervention and after 3 months of intervention. Results Conventional group had obvious reductions in the total score and the scores on social interaction,somatic movement and self-care subscales of the ABC Scale after 3 months of treatment(t=5.505,3.102,3.425,4.058,P<0.05). After 3 months of treatment, the PRT group had distinct reductions in the total score and the scores on sense,social interaction,somatic movement, language and self-care subscales of the ABC Scale as well as an obvious reduction in the total score of the CARS(t=6.087,2.861,4.618,5.509,5.621,6.578,7.398,P<0.05). The PRT group had a significantly greater reduction in the total score of the ABC Scale,social interaction,somatic movement,language,self-care and the total score of the CARS Scale than the conventional group(t=8.965,5.488,3.761,5.508,2.612,5.618,P<0.05). Conclusions PRT can effectively improve social interaction,somatic movement,language and self-care of ASD children.
    Emotion regulation strategies and family function in non-suicidal self-injury adolescents
    ZHAO Tian-xin, ZHONG Yi-juan, WEI Ying-juan, SU Yan-li, DANG Yun-hao, WU Xian-liang
    2021, 29(9):  946-950.  DOI: 10.11852/zgetbjzz2021-0339
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    Objective To explore the feature of emotion regulation strategies and family function in adolescents who suffered from non-suicidal self-injury(NSSI),in order to provide reference for the prevention and intervention of NSSI. Methods A total of 7 869 middle school students from Xi'an and Baoji in Shaanxi Province were selected into this study in January 2021, and were asked to fill in the Family Adaptability and Cohesion Evaluation Scales(FACES),Emotion Regulation Questionnaire(ERQ),Beck Depression Inventory-Ⅱ(BDI-Ⅱ)and self-developed general information questionnaire to screen adolescents with NSSI.The emotion regulation strategies and family function of adolescents with NSSI were investigated. Results The adolescents who have reported NSSI tended to use the expressive suppression strategy with lower family adaptability and cohesion(χ2=176.637,194.786,202.284,t=9.620,P<0.05).Logistic regression analysis showed that male,high cognitive reappraisal score and high family closeness were protective factors for NSSI(OR=0.55,0.65,0.98),while high expressive suppression score and depression were risk factors for NSSI(OR=1.27,1.08,P<0.05). Conclusions NSSI among adolescents is closely related to emotional regulation strategies and family functions.Adolescents and their parents may benefit from psychological interventions focused on emotional regulation strategies and family functions.
    Relationship between depressive symptoms and adverse childhood experiences of rural middle school students
    LIU Xia, ZHANG Yue-bing
    2021, 29(9):  951-954.  DOI: 10.11852/zgetbjzz2021-0011
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    Objective To investigate the prevalence of depressive symptoms among rural middle school students in Jining City,and to explore the influence of adverse childhood experiences(ACEs) on adolescent depressive symptoms. Methods From March to April 2019,students in 2 junior middle schools in Jining City were randomly selected. Childhood Trauma Questionnaire(CTQ-SF) and Center for Epidemiological Studies Depression Scale(CES-D) were used to investigate the psychological conditions of students. Results Among 715 rural junior high school students,218(30.5%) had depressive symptoms.Students had significantly different self-rating depression scores in different family structure and family income groups(F=7.397,4.169, P<0.05).No significant difference was found in self-rating depression scores among different gender,grade,only child or not,and left behind status groups(P>0.05). Significant differences were found in the scores of adverse childhood experience among different grade,family structure,monthly family income and left-behind status groups(P<0.05).Adverse childhood experiences were positively correlated with depressive symptom(r=0.198—0.481,P<0.05). Multiple linear regression analysis showed that parents' divorce(b=7.037),family monthly income <5 000 yuan(b=2.219,2.212),emotional abuse in childhood(b=1.555),sexual abuse(b=0.615)and emotional neglect(b=0.203) were positively related to depressive symptoms(P<0.05). Conclusions There are some depressive symptoms in rural middle school students in Jining City. Adverse childhood experience may increase the risk of adolescent depressive symptoms,so it is supposed to reduce the occurrence of adverse childhood experience in order to improve adolescent depressive symptoms.
    Association between prenatal maternal iron deficiency anemia and autism spectrum disorders in the offsprings
    LIU Xian, GUO Cheng, ZHUO Mu-chun, CHEN Yi-ru, CHEN Wen-xiong
    2021, 29(9):  955-959.  DOI: 10.11852/zgetbjzz2020-1818
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    Objective To explore the association between prenatal iron deficiency anemia and later risk of offspring' autism spectrum disorders(ASD),so as to provide clues for the early prevention and intervention for ASD. Methods A total of 145 children diagnosed with ASD(ASD group)and 251 healthy children(control group)were enrolled in this cross-sectional study in 2018-2020.The questionnaires were used to collect general family information and prenatal iron deficiency information.Univariate and multivariate Logistic regression analysis were conducted to examine the association between prenatal iron deficiency and the risk of offspring's ASD.Mediation analysis was further performed to investigate whether the relationship between prenatal iron deficiency and offspring's ASD was mediated by cesarean delivery,preterm or low birth weight. Results Compared with the control group,ASD children's mothers had a higher rate of prenatal iron deficiency(21.31% vs.7.56%,P<0.001).Children exposed to prenatal iron deficiency had an increased risk of ASD(OR=3.31,95%CI:1.73—6.32).After adjusting the variables such as child's sex,maternal education level,maternal passive smoking rate,nutrient supplementation in early pregnancy,the aforementioned trends remained.The association of prenatal iron deficiency with offspring's ASD was not mediated through cesarean delivery(indirect effect OR=0.99,95%CI:0.94—1.05),preterm(indirect effect OR=1.00,95%CI:0.95—1.08),or low birth weight(indirect effect OR=0.99,95%CI:0.94—1.04). Conclusions Prenatal iron deficiency is associated with an increased risk of the development of the offspring's ASD.Given that iron deficiency is common among pregnant women,early screening for iron deficiency anemia and nutrition counseling in antenatal care is necessary in reducing the risk of offspring's ASD.
    Basic Experimental Articles
    Association of obesity major gene SH2B1 with cognitive and social functions of autism spectrum disorder
    LI Chen-rui, LI Qi, ZHANG Yan-cheng, LI Xiang, YU Di, SHI Ya-xin, FAN Li-li, WU Li-jie
    2021, 29(9):  960-964.  DOI: 10.11852/zgetbjzz2021-0439
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    Objective To discuss the association between the obesity major gene SH2B1 and the cognitive and social functions of autism spectrum disorder(ASD),so as to provide ideas for the etiology of ASD. Methods Using animal behavior tests and RNA-seq,the differences in cognitive and social level and SH2B1 gene expression levels between BTBR mice(n=6)and control mice(n=6)were compared.SH2B1 knockout mice(SH2B1-/- mice)(n=6)were constructed,then the differences in cognitive level and social function between them and control mice were compared.Western-blot experiment was used to explore the changes in the phosphorylation level of cognitive-related proteins in the hippocampus of SH2B1-/- mice. Results Compared with control mice,BTBR mice had lower cognitive level(P<0.05),lower social skills(P<0.05),and down-regulation of SH2B1 gene expression level(P<0.05).Compared with control mice,SH2B1-/- mice showed lower cognitive level(P<0.05)and impairment of social function(P<0.05).Cognitive-related proteins CREB and CaMKⅡ phosphorylation levels of SH2B1-/- mice were significantly reduced than those in control group(t=2.74,3.62,P<0.01). Conclusion The SH2B1 gene may be highly related to the impairment of cognitive and social functions of ASD.
    Review
    Research progress on the mechanism of the detection of communicative intention in infants
    LIN Tong, DENG Yu-jiao, WU Yan, CHEN Min, WANG Guang-hai, JIANG Fan
    2021, 29(9):  965-968.  DOI: 10.11852/zgetbjzz2021-0019
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    During interpersonal interaction,communicators need to get addressee to recognize communicative intention so as to express communicative information. Ostensive signals are main approaches of expressing communicative intention. Newborns are able to detect the communicative intention via ostensive signals. Medial prefrontal cortex is critical for infants to detect communicative intention. Future study should measure the brain activation thoroughly and pay more attention to the detection of communicative intention in the communicative environment with more than one ostensive signal. In addition,the influence of individual differences and early growing environment on detection of communicative intention need more attention. Last but not least,future studies are supposed to focus on special infants.
    Characteristics of language development in children with autism spectrum disorders
    ZHAO Jin-zhu, TANG Li-na, HE Tian-yi, XIONG Ting-ting, YAN Tian, LI Jin-hui, WU Dan-dan, HAO Yan
    2021, 29(9):  969-972.  DOI: 10.11852/zgetbjzz2021-0392
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    Autism spectrum disorders(ASD) are common developmental disorders in childhood with a high disability rate.Language disorder is the most common comorbidity in children with ASD, and its early recognition, diagnosis and early targeted intervention measures are of great significance to improve the prognosis of ASD.This article will review the language development characteristics of ASD.
    Research progress of infant colic
    CHEN Xia, LIU Fang-li, WANG Ying, LI Rui
    2021, 29(9):  973-977.  DOI: 10.11852/zgetbjzz2020-1300
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    Recently infant colic is the research hotspot of pediatric healthcare. Little agreement has been reached on the definition, pathogenesis or the optimal management strategy for infant colic. This article gives an overview of the diagnostic, pathophysiology, managements of infant colic, so as to provide references for clinical practice and further researches.
    Possible mechanisms of vitamin D affecting neonatal jaundice
    HUANG Xin-Lin, ZHAO Lin
    2021, 29(9):  978-980.  DOI: 10.11852/zgetbjzz2020-1341
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    Vitamin D is an important liposoluble vitamin, which can not only regulate calcium and phosphorus metabolism, but also have the functions of anti-oxidation, anti-infection, immunomodulation, promoting cell proliferation and differentiation. Recent studies have found that different levels of serum vitamin D are also associated with neonatal jaundice. In view of many influencing factors of neonatal jaundice, this review combs the possible mechanism of vitamin D affecting neonatal jaundice.
    Review on the early neurological assessment of high-risk infants
    HAN Jia-le, WANG Jing-gang, CAO Jian-guo
    2021, 29(9):  981-985.  DOI: 10.11852/zgetbjzz2020-1055
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    With the improvement of neonatal treatment in China,the survival rate of high-risk infants has been significantly increased. Early identification of high-risk infants and early intervention can significantly improve the prognosis.It is very important to select an assessment tool with good reliability and validity. At present,early neurological assessment methods of domestic high-risk infants mainly include General Movements(GMs),Test of Infant Motor Performance(TIMP),Hammersmith Infant Neurological Examination(HINE),Neonatal Behavioral Neurological Assessment(NBNA),the 20 items neuromotor assessment from birth to 1 year old,Vojta posture reflex examination,Peabody Developmental Motor Scale(PDMS). Infant Motor Profile(IMP) and Harris Infant Neuromotor Test(HINT) are also used at abroad. In this paper,these neurological assessment tools will be reviewed.
    Meta Analysis
    Literature analysis of exercise intervention study on overweight and obesity in children andadolescents with intellectual disability from 2010 to 2020
    BU Qing-guo, ZHANG Lei, WANG Dan-dan, WU Xue-ping
    2021, 29(9):  986-991.  DOI: 10.11852/zgetbjzz2020-1484
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    Objective To systematically analyze the methodological features and effects of intervention on overweight and obesity in children and adolescents with intellectual disability, so as to provide reference for health promotion of these children. Method The literatures were searched in WOS, EBSCO and PubMed, and the samples, intervention methods and effects were summarized. Results Totally 11 articles were included, of which 8 were simple exercise intervention, 3 were comprehensive intervention.And the effective intervention was 64%. Intervention with 30—60 min/time, 2—5 times/week, 9—16 weeks received best effect. In addition, there was a lack of analysis of the differences in gender, age and level of barriers. The programme was mainly implemented in schools by professionals such as coaches, so an exploration of special education teachers, parents and other implementation environments was warranted. Moreover, control group setting was lacked and evaluation methods were not uniform. Conclusions Regular and organized exercise participation can significantly improve the overweight and obesity of children and adolescents with intellectual disability. However, the dose-effect relationship between exercise participation and obesity intervention needs to be further studied.
    Meta-analysis of risk factors for acute attack of asthma in Chinese children
    LI Yu-jian, WANG Yang, KAN Xuan
    2021, 29(9):  992-995.  DOI: 10.11852/zgetbjzz2020-1045
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    Objective To systematically evaluate the main risk factors for acute attack of asthma in Chinese children,and to provide basis for early prevention,treatment and improvement of prognosis of acute attack of asthma in children. Methods Databases of CNKI,Wanfang Data,VIP,Web of science,PubMed,Cochrane and Embase were searched to systematically collect literatures from the establishment to May 31st,2020 to study the risk factors of Chinese children's acute asthma attack.The data were screened and extracted by two persons independently for quality control,and the RevMan5.3 software provided by Cochrane was used for Meta-analysis. Results A total of 8 case-control studies were included in the qualitative analysis,of which 7 were evaluated quantitatively,including 1 170 cases in the case group and 882 cases in the control group.Meta-analysis showed that the main risk factors for acute attack of asthma in children included history of respiratory tract infection(OR=1.68,95%CI:1.20—2.35),history of passive smoking(OR=1.99,95%CI:1.47—2.69),family history of asthma(OR=2.11,95%CI:1.57—2.84),history of allergy in children(OR=3.84,95%CI:2.27—6.48)and unstandardized medication(OR=2.83,95%CI:1.69—4.75),while breastfeeding was a protective factor(OR=0.48,95%CI:0.31—0.72). Conclusions There are many risk factors for acute attack of asthma in Chinese children,among which the history of allergy is the primary risk factor,followed by unstandardized medication and family history of asthma,while breastfeeding can reduce the risk of acute attack of asthma in children.
    Clinical Research
    Effects of family environment and parental rearing styles on sleep behaviors of preschool children
    HE Hai-yan, WANG Rui, NING Man, YU Min, ZHANG An-hui
    2021, 29(9):  996-999.  DOI: 10.11852/zgetbjzz2021-0792
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    Objective To analyze the influence of parents' rearing styles and family environment on the sleep quality of preschool children,so as to provide basis for improving children's sleep. Methods Seven kindergartens in Wuhu city were randomly selected to conduct this survey from May to June 2017. The socioeconomic status was estimated by Green's scoring. The Parent Behavior Inventory(PBI) and the Children's Sleep Health Questionnaire(CSHQ) were used to evaluate the parenting style and the sleep condition of children. Results A total of 2 201 preschool children were investigated. There was no difference in the total score of sleep behavior between boys and girls(49.79±4.65 vs. 49.80±4.91,t=0.04,P>0.05). Totally 320(14.54%) children had sleep disorder. The scores of parental hostility/compulsive parenting style in the sleep problem group were higher than that in the non-sleep problem group(t=6.31,5.58, P<0.001),while the scores of father's support/participation parenting style in the sleep problem group were lower than that in the non-sleep problem group(t=2.27,P<0.05). Multivariate analysis showed that the higher the scores of parent and parent hostile/compulsory parenting style,the higher the risk of sleep problems in preschool children(OR=1.04,95%CI:1.01—1.06;OR=1.04,95%CI:1.02—1.07),while father support/participation in parenting decreased the risk of children's sleep disorder(OR=0.98,95%CI:0.96—1.00). In terms of family factors,the distance between the family and the main road <50 m could increase the occurrence of sleep disorder in children(OR=1.68,95%CI:1.07—2.63). Conclusions Parenting style is closely related to children's sleep problems. So parents are suggested to adopt more positive education methods when they get along with them. Secondly,the distance between families and main roads should be strictly regulated,which will lay a foundation for the healthy development of preschool children.
    Epidemiological study on the development of visual acuity and refraction in teenagers in Minhang district of Shanghai
    XU Xiao-li, GAO Lu, YANG Chen-hao
    2021, 29(9):  1000-1003.  DOI: 10.11852/zgetbjzz2021-0214
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    Objective To investigate the refractive status in teenagers in the Minhang District of Shanghai,so as to provide reference for the development of prevention and treatment strategies of children's eye diseases in Shanghai. Methods A cross-sectional study was conducted. From March to September 2019,a total of 15 590 teenagers from 14 schools in Minhang district of Shanghai were selected into this study and took visual examinations,including visual acuity measurement(standard logarithmic visual acuity chart),auto refraction and ocular health examination. Results Finally 15 527 teenagers successfully completed their vision screening. There were 8 230 boys and 7 297 girls. The prevalence rate of uncorrected visual acuity ≤4.7 in both eyes was 21.62%(3 357/15 527),with the wearing glasses rate of 65.68%(2 205/3 357). The prevalence rates of myopia,high myopia and astigmatism in girls(44.65%,3.00%,24.80%) were higher than those in boys(39.81%,2.26%,23.17%). In addition,with the increase of age,the prevalence of myopia and high myopia gradually increased(χ2=1 962.095,787.617,P<0.05). Logistic regression analysis showed that myopia was associated with age(OR=1.339,95%CI:1.321—1.358,P<0.001) and female(OR=1.230,95%CI:1.149—1.317,P<0.001). Conclusions Teenagers in Minhang district of Shanghai have a high prevalence of refractive error. The prevalence of myopia and high myopia is associated with age and female. However,longitudinal studies are warranted to evaluate refractive changes over time in individual children,and related measures should be carried out to prevent the development of myopia.
    Evaluation of the application of third-generation stereoscopic examination chart in preschool children's near stereoscopic examination
    TONG Huan, CHEN Wei, FENG Jing-jing, PU Jia-ning
    2021, 29(9):  1004-1007.  DOI: 10.11852/zgetbjzz2020-1233
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    Objective To explore the applicability of Yan's Third-Generation Stereoscopic Test Charts(Yan Random Dot Stereo 3, YRDS3) in preschool children, in order to provide reference for choosing an appropriate method in preschool children's near stereoscopic examination. Methods A cross-sectional study was conducted in 1 021 children aged 3—6 years from 5 kindergartens in Haidian District.All children were examined for visual acuity, ocular deviation, YRDS3 and Titmus near stereoscopic examination.According to whether vision and ocular deviation are normal, children were divided into normal group and abnormal group.The stereoacuity results of the two stereopsis examination methods were statistically analyzed, and the stereopsis distribution characteristics of children of all ages were observed.The differences of stereopsis distribution between the two groups and the consistency of the two examination methods were compared. Results The success rate of 3-year-old children's YRDS3 examination was 86.0%, and that of 4-year-old children was 93.9%.There was statistical difference in stereoscopic distribution between normal vision and ocular deviation group and abnormal group(Z=3.891, 4.376,P<0.05).The P95 values of 3-year-old, 4-year-old, 5-year-old and 6-year-old children's Titmus in normal group were 200″, 100″, 60″ and 70″, respectively.And the P95 values of YRDS3 for those were 91″, 60″, 60″and 60″respectively.For children older than 6 years old, the results of YRDS3 were consistent with those of Titmus(Z=1.732,P>0.05). Conclusions YRDS3 is suitable for preschool children.The stereoacuity of 3- to 4-year-old children has reached 60″, which supports Guo Jing-qiu's conclusion that the stereoacuity of children is at 3 years old.
    Clinical diagnostic value of interleukin-17,interleukin-27 and exhaled nitric oxide alone or combination in children with bronchial asthma
    LIU Yang, GAO Wei-xia, SONG Zhe, ZHU Yong-jie
    2021, 29(9):  1008-1011.  DOI: 10.11852/zgetbjzz2020-1738
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    Objective To detect the correlation between fractional exhaled nitric oxide(FeNO),interleukin-17(IL-17),interleukin-27(IL-27)and lung function indexes,and to analyze the clinical diagnostic value for bronchial asthma in children. Methods A total of 84 children diagnosed with bronchial asthma in Nanyang Central Hospital were prospectively enrolled in this study from January 2019 to April 2020,meanwhile 56 healthy children were selected as control group.IL-17,IL-27 and FeNO levels of peripheral blood were tested,and pulmonary function-related indicators were recorded,including forced expiratory volume in one second(FEV1),forced expiratory volume in one second and vital capacity ratio(FEV1/FVC),peak expiratory flow rate(PEF),and ratio of residual volume to total lung volume(RV/TLC).Pearson correlation analysis was used to detect the correlation between IL-17,IL-27 and FeNO with lung function indexes.The ROC working curve was used to evaluate the diagnostic value of FeNO combined with IL-17 and IL-27 detection in childhood asthma. Results The differences of IL-17,IL-27,FeNO,FEV1,FEV1,FEV1/FVC,PEF and RV/TLC among the control group,stable phase and acute exacerbation phase groups were statistically significant(F=137.241,92.074,94.296,16.325,174.263,31.174,115.207,P<0.001).In children with asthma,IL-17 level was negatively correlated with FEV1,FEV1/FVC and PEF(r=-0.690,-0.576,-0.613),and positively correlated with RV/TLC(r=0.581).IL-27 level was negatively related to FEV1,FEV1/FVC and PEF(r=-0.786,-0.818,-0.549),and positively related to RV/TLC(r=0.513).FeNO level was negatively correlated with FEV1,FEV1/FVC and PEF(r=-0.667,-0.662,-0.637),and was positively correlated with RV/TLC(r=0.543).The sensitivity of IL-17,IL-27 and FeNO in the diagnosis of childhood asthma was 52.4%,68.5% and 70.6%,the specificity was 76.2%,63.2% and 65.3%,and the area under the curve was 0.684(95%CI:0.614—0.725),0.768(95%CI:0.710—0.805),0.792(95%CI:0.723—0.840),respectively.The sensitivity of the combined test for diagnosis of childhood asthma was 86.9%,the specificity was 81.4%,the area under the curve was 0.905(95%CI:0.802~0.941),and the difference was statistically significant compared with the single test(P<0.05). Conclusions The levels of IL-17,IL-27 and FeNO are correlated with lung function indexes.Joint detection can significantly improve the sensitivity and specificity of the diagnosis of bronchial asthma in children.
    Clinical characteristics and risk factors of necrotizing enterocolitis in very premature infants
    DONG Hui-min, SONG Juan, WANG Yong, ZHANG Xiao-li, JUE Zhen-zhen, WEI Le-le
    2021, 29(9):  1012-1016.  DOI: 10.11852/zgetbjzz2021-0000
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    Objective To investigate the clinical characteristics and risk factors of necrotizing enterocolitis (NEC) in very preterm infants, in order to provide reference for preventing NEC. Methods A retrospective case-control study was performed during January 2012 to November 2019 on 113 very preterm infants with NEC and 113 infants without NEC in the neonatal intensive care unit of the Third Affiliated Hospital of Zhengzhou University. The clinical characteristics of NEC in very premature infants were investigated and the risk factors of NEC were analyzed by Logistic regression. Results 1) NEC occurred at the age of [12.0 (5.0—22.5)] days old in very preterm infants. Infants with NEC stage Ⅲ had earlier onset age (Z=3.05,P=0.002), lower birth weight (t=2.46,P=0.015) and higher mortality (χ2=63.65,P<0.001) compared with infants with NEC stage Ⅱ. 2) The clinical manifestations of very preterm infants with NEC were mainly abdominal distention, apnea, gross blood stool and emesis. Abdominal distention in infants with NEC stage Ⅲ were more severe than that with NEC stage Ⅱ(χ2=5.09,P=0.024). 3) The incidence of severe asphyxia, mechanical ventilation, grade III—IV RDS, sepsis and the proportion of boys in infants with NEC stage Ⅲ were higher than that with NEC stage Ⅱ(χ2=4.69, 8.51, 5.32, 3.89, 5.75, P<0.05 or 0.01). Feeding rate and feeding amount in infants with NEC stage Ⅲ were significantly lower compared with infants with NEC stage Ⅱ(χ2=12.32, Z=3.93, P<0.001). 4) Logistic regression analysis showed that male infants(OR=1.888, 95%CI: 1.019—3.499, P=0.043), sepsis(OR =6.866, 95%CI: 3.522—13.385, P<0.001) and hypocalcemia (OR=2.684, 95%CI: 1.053—6.840,P=0.039) were risk factors for NEC in very premature infants, while breastfeeding(OR=0.318, 95%CI:0.108—0.933, P=0.037) was a protective factor. Conclusions The clinical manifestations of NEC in very premature infants vary with the severity of the disease. Early identification of high-risk premature infants should be strengthened in clinical practice, and preventive measures should be taken early to reduce the incidence of NEC.
    Study on the correlation between DNA load of drug-resistance mycoplasma pneumoniae and 23sRNA mutation at 2063 locus in children
    ZHU Mei-jun, JI Ju-hua, ZHU Jie, SONG Lei, ZHOU Feng, ZHAO Jin-hua
    2021, 29(9):  1017-1020.  DOI: 10.11852/zgetbjzz2020-1544
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    Objective To explore the correlation between DNA load of drug-resistance mycoplasma pneumonia(MP) and 23sRNA mutation at 2063 locus in children, in order to provide evidence for the treatment of MP pneumonia. Methods A total of 158 children with MP pneumonia who were treated in Nantong First People's Hospital from December 2017 to December 2019 were enrolled in this study.The drug sensitivity tests were performed on all patients.According to the results of drug-resistance to antibiotics, patients were divided into resistance group(n=112) and non-resistance group(n=46).The MP load index(MPLI) and mutation rate of 23sRNA gene at 2063 locus were compared between resistance group and non-resistance group.The relationship between MPLI and clinical indexes was analyzed.The diagnostic value of MPLI for drug-resistance MP pneumonia was analyzed by ROC curves.The correlation between MPLI and mutation of 23sRNA gene at 2063 locus was analyzed. Results MPLI in resistance group was significantly lower than that in non-resistance group(t=4.373, P<0.001).AUC and cut-off value of MPLI for diagnosis of drug-resistance MP pneumonia were 0.698 and 5.16, respectively.The proportion of cases with defervescence time not shorter than 3 days, disappearance time of cough and expectoration not shorter than 5 days, disappearance time of chest shadow not shorter than 10 days and extrapulmonary complications in positive MPLI group was higher than that in negative MPLI group(χ2=17.584, 19.237, 44.724, 11.075, P<0.001).Multivariate Logistics regression analysis showed that defervescence time ≥3 days, disappearance time of cough and expectoration ≥5 days, disappearance time of chest shadow ≥10 days and extrapulmonary complications were influencing factors of MPLI expression in children with MP pneumonia(OR=1.420, 1.573, 1.670, 1.598, P<0.001).The mutation rate of 23sRNA gene at 2063 locus in resistance group was significantly higher than that in non-resistance group(χ2=52.484, P<0.001).The expression level of MPLI was negatively correlated with 23sRNA gene mutation at 2063 locus(r=-0.538, P<0.001). Conclusions The expression of MPLI is related to clinical indexes such as disappearance time of clinical symptoms in children with MP pneumonia, which is negatively related to the mutation rate of 23sRNA gene at 2063 locus.MPLI expression is of diagnostic value for drug-resistance MP pneumonia.
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    Comparative study on the mortality rate of children under 5 years old between China and Russia from 1990 to 2017
    LI Ming-yang, WANG Shu-xia, LIU Xi-bo, WANG Yun, CAO Jing, HU Ji-hong
    2021, 29(9):  1021-1025.  DOI: 10.11852/zgetbjzz2020-1228
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    Objective To analyze the differences between the deaths of children under 5 years old in China and Russia from 1990 to 2017, so as to provide basis for promoting the joint prevention and treatment cooperation between children under 5 years old. Methods Report data on mortality of children under 5 years of age from 1990 to 2017 were extracted from the World Bank database,and report data on death rate by cause of death from 2000 to 2017 were collected from the World Health Organization database.Pearson analysis was used to analyze the trend of mortality in the two countries over time, χ2 test was used to examine the difference in annual mortality and cause-specific mortality between China and Russia. Results From 1990 to 2017,both China and Russia's under-five mortality rate and gender mortality rate showed a downward trend(P<0.05),but decline rate of children in China was faster than that of Russia. China's injuries,childbirth injuries and suffocation,acute lower respiratory tract infections,and other infections,perinatal and nutritional status deaths accounted for higher proportions than Russia,while Russia's deaths from premature birth,congenital anomalies,and other non-communicable diseases accounted for higher proportions than China.However,the decline was lower than that in China,and since 2004 the top two causes of death in both countries have been premature birth and congenital abnormalities.The annual HIV/AIDS mortality rate in Russia was higher than that in China(P<0.05).Since 2010,the HIV/AIDS mortality rate and the proportion of death causes have increased,with an average annual growth rate of 16.54%. Conclusions Over the past 28 years,China and Russia have achieved remarkable results in reducing the deaths of children under 5 years old.Compared with Russia,China has a large proportion of infectious and traumatic diseases,and the rapid decline may be the main reason for the rapid decline in the mortality rate of children under 5 years old.Further reducing premature birth and congenital abnormal deaths is the key to decreasing the mortality rate of children under 5 in both countries.Crucially,Russia should also pay attention to HIV/AIDS prevention and treatment for pregnant women.
    Comparative study on hyperbilirubinemia and its related factors between neonates born in Aksu and Yibin
    WANG Wen-hui, JIANG Jun-shan, HU Chi, MIU Xue-yu, ZHANG Min, CHEN Zhe
    2021, 29(9):  1026-1029.  DOI: 10.11852/zgetbjzz2020-1776
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    Objective To design the hour-specific bilirubin nomogram of Han newborns in the first 120 hours after birth, and to compare the difference in the trends of the hour-specific bilirubin and the incidence of hyperbilirubinemia between newborns in Aksu and Yibin, so as to provide evidence for the prevention, assessment and treatment of hyperbilirubinemia. Method From January 2018 to December 2019, healthy Han infants were selected in this study, who were born in the obstetrics department of the Third People's Hospital of Yibin and the obstetrics department of the Corps First Division Hospital's of Aksu. The related research indexes that may be related to neonatal jaundice were recorded detailedly. The transcutaneous bilirubin(TCB) value of 5 days after birth was monitored. TCB percentiles(P25,P50,P75) of each period were calculated and plotted. At the same time,the influence of related perinatal factors on neonatal hyperbilirubinemia was statistically analyzed. Results A total of 1 605 cases were included in this study. The TCB percentiles of the Han neonates in Yibin area were higher than those in Aksu at same time points. The incidence of hyperbilirubinemia of Han neonates in Yibin was higher than that of Aksu(χ2=118.5,P<0.001). Premature, first feeding time>24 h,the application of oxytocin in pregnant women and cephalohematoma were risk factors of hyperbilirnbinemia(OR=8.331,19.640,2.982,4.019). Conclusions The bilirubin level of neonates increases with the growth of age within 5 days after birth,and the rising rate of hour-specific bilirubin of Yibin neonates is higher than that of Aksu neonates.The incidence of hyperbilirubinemia of Yibin neonates is also higher than that of Aksu neonates.
    Occurrence and influencing factors of extrauterine growth retardation in premature infants not older than 34 weeks old
    HU Xiao-shan, ZHANG Jun, LI Meng-meng, YU Zhang-bin
    2021, 29(9):  1030-1033.  DOI: 10.11852/zgetbjzz2020-1261
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    Objective To explore the incidence and influencing factors of extrauterine growth retardation(EUGR) in premature infants with gestational age ≤ 34 weeks old, in order to provide reference for facilitating the healthy growth and development of preterm infants. Methods The clinical data of 315 premature infants whose gestational age was ≤ 34 weeks and were delivered in Nanjing Maternal and Child Health Hospital from January 2016 to January 2018 were retrospectively collected and analyzed.According to whether infants had EUGR or not, infants were divided into developmental retardation group(retardation group) and typical development group(normal group).The influencing factors of EUGR in preterm infants were analyzed by multivariate Logistic regression analysis. Results The proportions of birth weight <1 500 g, gestational age<28 weeks, head circumference at birth ≤33 cm, duration of body mass decline >6 d, maternal gestational hypertension, minimum body weight and body mass at discharge indevelopmental retardation group were significantly higher than those in typical development group(P<0.05).And the first breastfeeding time, time for achieving enteral feeding, intravenous nutrition duration, duration of minimal feeding, the proportions of sepsis, respiratory distress syndrome and feeding intolerance were significantly higher than those in typical development group(P<0.05).Multivariate Logistic regression analysis showed that birth weight<1 500 g(OR=1.719, 95%CI:1.115—2.652), gestational age <28 weeks(OR=1.587, 95%CI:1.052—2.396) and time for achieving enteral feeding≥17 d(OR=1.835, 95%CI:1.144—2.943) were risk factors of EUGR in premature infants(P<0.05). Conclusions The influencing factors of EUGR in premature infants with gestational age is ≤34 weeks include birth weight, gestational age and time for achieving enteral feeding.And nutritional support should be taken as soon as possible to reduce EUGR risk.
    Comparison of the effect of different methods on preventing caries in children's first permanent molar
    ZHENG Jin-chuan, LIN Hang, QIU Dong-hai, HUANG Ze-hong, DAI Wei-ting, LIU Yong-jie
    2021, 29(9):  1034-1037.  DOI: 10.11852/zgetbjzz2020-1407
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    Objective To longitudinally observe the preventive effect of pit and fissure sealants,fluorogel,fluorinated foam,and oral health instruct(OHI) on preventing caries in the first permanent molar of the second grade children(7 to 8 years old) in Quanzhou,so as to find the best method for preventing the first permanent molar caries prevention in schools. Methods Totally 1 768 second-grade children in 5 schools were selected by cluster random sampling method in Quanzhou city area in 2017 to check the eruption of the first permanent molar and caries. Students in five schools were divided into five groups,including control group(n=313),OHI group(n=421),fluoride protective paint group(n=267),fluoride-containing foam group(n=438) and pit and fissure sealing group(n=329) . The anti-caries effects of five primary schools were compared in two years. Results Finally 1 748 children from five primary schools completed the two-year observational study,and the follow-up rate was 98.87%. After two-year intervention,new decayed, missing of filled teeth(DMFT) and new decayed, missing of filled surface(DMFS) in fluoride protective paint group were higher than those in other four groups,which were lowest in pit and fissure sealing group,and the difference was significant(P<0.05). Conclusion The four preventive methods have different effects on the prevention of caries on the first permanent molars of children aged 7 to 8 years,of which pit and fissure sealing has the best effect.