Table of Content

10 February 2023, Volume 31 Issue 2

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Guideline/Consensus/Recommendations

Expert recommendations for prevention and coping strategies on psychological and behavioral problems of children and adolescents during home quarantine/online learning (the 2nd Version)

2023, 31(2):  117-122.  DOI: 10.11852/zgetbjzz2022-1469

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Children and adolescents are vulnerable to major public health stress events. Since the outbreak coronavirus disease 2019 (COVID-19) in December 2019, home quarantine and online learning have been adopted to contain the spread of COVID-19. In view of the increasing social and psychological behavioral problems of children and adolescents during the COVID-19 pandemic, as well as the long-term or intermittent home quarantine and online learning in the post-COVID-19 period, the Developmental Behavior Pediatrics Group of Chinese Pediatric Society formulated this recommendation, which is based on "Psychological impact of coronavirus disease 2019 on children and adolescents and recommendations for family intervention(1st version)" in 2020 and the current domestic situation. It is hoped that social and psychological support will be provided to children of all ages during home quarantine/online learning from family, school and health, and continue to implement coping strategies in the prevention and treatment of children′s social and behavioral problems in special periods.

Professional Forum

Brain injury and early assessment in infants

ZHANG Yu-ping

2023, 31(2):  123-125.  DOI: 10.11852/zgetbjzz2022-1560

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With the improvement of survival rate of critically ill neonates, the number of infants at high risk of brain injury has also increased.Clinicians need to recognize infant brain injury and grasp the methods of early identification of infant brain injury.In this paper, different types of infant brain injury and their long-term development outcomes are briefly described, and the early assessment of infant brain injury is introduced from three aspects: clinical history, auxiliary examination and standardized evaluation, thereby providing reference for early intervention and improvement of long-term development outcomes of infants with brain injury.

Original Articles

Cohort study of allergic exposure at different time points and neuropsychological development in children

WENG Ting-ting, GAO Guo-peng, WANG Qiong-yao, XIE Liang-liang, LI Chun-gang, YAN Shuang-qin, TAO Fang-biao

2023, 31(2):  126-130.  DOI: 10.11852/zgetbjzz2022-0870

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Objective To describe the incidence of allergies in different periods of early childhood, and to analyze the correlation between anaphylactic diseases and children′s neurodevelopment in prenatal and childhood. Methods During February 2015 to August 2016, 2 212 pregnant women who had their first antenatal examination at Ma′anshan Maternity and Child Health Hospital were recruited in this cohort, and were followed up until children were 36 months old. Information of allergy in prenatal and early childhood was collected by filling out questionnaires. The Ages and Stages questionnaire (ASQ) was used to evaluate 36-month-old children′s neurodevelopment including communication (CM), fine motion (FM), gross motion (GM), problem-solving (CG) and personal-social (PS) development. Both "near the threshold" and "below the threshold" were defined as abnormal development. Results Finally 1 742 children completed survey at 36 months old, of whom 52.0% were boys and 48.0% were girls. The incidences of allergic diseases in mothers before and during pregnancy were 22.6% (480/2 120) and 13.5% (254/1 882), respectively. The incidences of allergic and in infants at the age of 3, 12 and 24 months were 36.0% (713/1 981), 26.0% (472/1 816) and 22.3% (352/1 581), respectively. Univariate analysis showed that there was only significant difference in ASQ results in children whose mother had pre-pregnancy allergy or not. There was a significantly positive correlation between maternal pre-pregnancy allergy and abnormal development of fine motor at 36 months old. After adjusting gender, only child or not, family incomes and maternal age, the correlation was still statistically significant (aOR=1.89, 95%CI: 1.04 - 3.42). Conclusions Allergy is common in both prenatal period and early childhood. Attention should be paid to the potential harmful effects of maternal allergy on children′s neurodevelopment, and further researches on the mechanism are warranted.

Effect of COPM-based occupational therapy on occupational performance and activities of daily living of children with global developmental delay

LI Yang, JIA Yu-feng, ZHANG Shuang, GAO Shu-zhi, GAO Jing-yun, LI Shuang

2023, 31(2):  131-135.  DOI: 10.11852/zgetbjzz2022-1264

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Objective To observe the effect of occupational therapy program based on the Canadian Occupational Performance Measure(COPM) on the performance of occupational activities, satisfaction and activities of daily living in children with global developmental delay(GDD), so as to provide reference for clinical practice in the formulation of occupational therapy for children with global developmental delay. Methods A total of 69 children with GDD who received rehabilitation treatment in the outpatient department of Child Rehabilitation of Tangshan Maternal and Child Health Hospital from March 2021 to March 2022 were selected and randomly divided into control group (n=35) and observation group (n=34) by random number table method. The control group received routine rehabilitation therapy. Additionally, the observation group replaced occupational therapy with a goal-oriented occupational therapy program based on COPM results, and the treatment lasted for 3 months. Before treatment and 3 months after treatment, COPM was used to evaluate Children′s performance and satisfaction with target tasks, and Child Functional Independence Measure for Children (WeeFIM) was used to evaluate the Children′s activities of daily living. Results After treatment, the COPM performance scores of the observation group and the control group were significantly improved compared with those before treatment (t=21.845, 7.533, P<0.05), and the improvement of observation group was better than that of the control group (t=2.551, P<0.05). The COPM satisfaction scores of the observation group and the control group were significantly improved compared with those before treatment (t=22.240, 8.329, P<0.05), and the improvement of observation group was better than that of the control group (t=2.300, P<0.05). The effectiveness rates of COPM performance score and satisfaction score in the observation group were significantly higher than those in the control group (χ²=4.183, 4.284, P<0.05). After treatment, scores of motor function, cognitive function and total score of WeeFIM in the observation group were significantly higher than those in the control group (t=2.132, 2.994, 2.364, P<0.05). Conclusion The occupational therapy program based on COPM can improve the occupational performance and satisfaction of the target tasks of children with GDD and can significantly improve the activities of daily living of these children.

Characteristics of intelligence structure in preschool children with attention deficit hyperactivity disorder and developmental coordination disorder

HUANG Qi, HUANG Xin-xin, QIAN Qin-fang, WANG Zhang-qiong, LI Guo-kai

2023, 31(2):  136-140.  DOI: 10.11852/zgetbjzz2022-0802

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Objective To analyze the characteristics of intelligence structure in preschool children with attention deficit hyperactivity disorder (ADHD) and developmental coordination disorder (DCD), in order to provide theoretical basis for targeted intervention of preschool children with ADHD and DCD. Methods From July 2020 to April 2022, preschool children diagnosed with ADHD in Fujian Provincial Maternity and Children′s Hospital were screened with Developmental Coordination Disorder Questionnaire (DCDQ). Children with suspicious and abnormal results were diagnosed using the American Psychiatric Association′s Diagnostic and Statistical Manual of Mental Disorders (5th edition) (DSM-5) as the diagnostic criteria. Finally, 70 ADHD children were diagnosed with DCD, and 50 children with ADHD were taken as the control group. Wechsler Infant Intelligence Scale was used to test the intelligence structure of all children in this study. Results The full scale intelligence quotient (IQ) (t=2.884), verbal comprehension (t=3.059),visual spatial (t=2.198),working memory (t=2.345)and processing speed index (t=3.314) of ADHD children comorbid with DCD were significantly lower than those with simple ADHD(P＜0.05). There was no significant difference in fluid reasoning index between children in the two groups (t=0.997, P＞0.05). Compared with the scores of 10 core subtests, the scores of ADHD children comorbid with DCD were lower than those of children with simple ADHD, among which the scores of information (Z=2.285), similarities (t=2.645), object assembly (t=2.225),zoo locations (Z=3.307),bug search (t=3.033) and cancellation (t=2.299) were significantly different (P＜0.05). Conclusions The total intelligence quotient of ADHD children comorbid with DCD is lower than that of simple ADHD children, which is mainly manifested in speech comprehension, visual space, working memory and processing speed index. Therefore, in addition to the traditional psychological behavior therapy, targeted intervention should be strengthened for preschool ADHD children comorbid with DCD in training and education.

Effect of caregiver skill training on improving the symptoms of children with autism spectrum disorder and psychological defense mechanism of their parents

WANG Hai-mei, YIN Hua-ying, LI Yan, DONG Qiu-jun, CHEN Jing, AO Dong-qin, LUO Shuang

2023, 31(2):  141-146.  DOI: 10.11852/zgetbjzz2022-0793

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Objective To explore the effectiveness of caregiver skill training in improving the symptoms of children with autism spectrum disorder (ASD) and parental psychological defense mechanism, so as to provide evidence for clinical intervention of autistic children. Methods A total of 120 ASD children and their parents who have seen a doctor in a tertiary care children′s hospital in Chongqing from May to November 2021 were selected as the study subjects and were divided into the control group and the intervention group according to the voluntary principle. The control group received conventional intervention, while children and parents in the intervention group received caregiver skills training for 6 weeks, of which online theoretical training lasted for 4 weeks with a frequency of 5 times/week, and offline practical skills training lasted for 2 week with a frequency of 1.5 hours/time, 5 times/week. Before the intervention, at the end of the intervention, and one month after the end of the intervention, the defense ability of parents in the two groups was assessed using the Defense Mechanism Questionnaire (DSQ), the intervention effect of the children in the two groups was evaluated using the Autism Behavior Checklist (ABC) and the infant-junior middle school social adaptive capacity scale(SM). Results At the end of the intervention, the score of immature defense mechanism of parents in the intervention group was 3.79 ± 1.29, which was significantly lower than that in the control group (4.28 ± 1.14) (t＝-2.281, P <0.05). One month after the end of the intervention, the scores of immature defense mechanism and intermediate defense mechanism of parents in the intervention group were significantly lower than those in the control group (t=-2.490, -2.196, P <0.05). The score of autism behavior checklist in the intervention group was 55.25±8.89, significantly lower than that in the control group (60.32±9.61) (t =-2.997, P<0.05), and the time effect was significant (F=73.54, P <0.05).At the end of the intervention and one month after the end of the intervention, compared with the control group, the number of children with moderate and severe abnormalities in social life ability in the intervention group was significantly reduced (Z＝-2.119,-3.164, P<0.05). Conclusion Caregiver skill training can effectively improve the immature defense mechanism of parents and reduce the symptoms of ASD children.

Associations between febrile seizures and frequent nocturnal enuresis in children

MAO Yi, SHEN Jia-yao, ZHONG Shao-gen, JIN Xing-ming, MA Jun

2023, 31(2):  147-151.  DOI: 10.11852/zgetbjzz2022-1022

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Objective To investigate the associations between febrile seizures and frequent nocturnal enuresis, so as to provide evidence for study of risk factors for enuresis and explore the changes of the associations in different ages and genders. Methods A stratified cluster random sampling method was used to select 85 860 children aged 5 to 12 years in 3 urban areas and 4 suburbs in Shanghai from June 2014 to June 2015, and children were asked to fill out questionnaire. Multivariate Logistic regression analysis was used to analyze the association between febrile seizures and frequent nocturnal enuresis. Sensitivity analysis was performed to observe the changes of association in ages and genders. Results Finally 62 290 valid questionnaires were enrolled in this study. Multivariate analysis showed that children with febrile seizures still had a high risk of enuresis after controlling for confounding factors (OR=7.740, 95%CI:5.512 - 10.870, P<0.001). In addition, the association between the two increased with ages (P<0.001), which was more significant in girls (OR=13.798, 95%CI:8.056 - 23.631, P<0.001) than boys (OR=4.422, 95%CI:2.580 - 7.579, P<0.001). Conclusion Febrile seizures is significantly associated with frequent nocturnal enuresis, especially in older age groups and girls, suggesting that FS is one of the risk factors for frequent nocturnal enuresis.

Plasma level of folate-related metabolites in children with autism spectrum disorder and its relationship with clinical manifestations

WANG Feng, ZHANG Yu-jue, ZHAO Jing-yi, LIU Ze-hui, ZOU Ming-yang, SUN Cai-hong, XIA Wei

2023, 31(2):  152-155.  DOI: 10.11852/zgetbjzz2021-1907

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Objective To explore the relationship between folic acid related metabolites and autism spectrum disorder (ASD), so as to provide theoretical basis for the etiology and pathogenesis of ASD. Methods From June 2017 to December 2018, children who received rehabilitation training in designated rehabilitation institutions for autism in Harbin were collected. Seventy autistic children and seventy matched healthy children were enrolled in this case-control study. The levels of folic acid related metabolites in plasma were measured by liquid chromatography tandem-mass spectrometry (LC-MS/MS), and its association with the clinical phenotype of ASD children was analyzed. Results ASD children had higher plasma levels of cystathionine (Z=2.59), total glutathione (tGSH) (t=5.29), homocysteine (Hcy) (t=2.23), cysteine (t=11.37), methionine (t=3.14) compared to healthy control (P<0.05), but the difference in the levels of adenosine(Z=1.20) and cystine(t=1.75) in plasma between the two groups was not significant (P>0.05). The level of tGSH in ASD children was positively correlated with the scores of social communication score in Social Responsiveness Scale (SRS) (r=0.322, P<0.05). Conclusion Abnormal expression of folic acid related metabolites in ASD children is correlated with the scores of clinical phenotypic features of ASD, and the underlying mechanism needs to be further explored.

Oral motor function and its correlation with consonant mispronunciation errors in children with functional articulation disorders

MA Liang, WANG Yan-xia, RAN Ni, SHAN Yan-chun, LIU Xiao-mei, LIU Yuan-yuan, YI Ming-ji

2023, 31(2):  156-161.  DOI: 10.11852/zgetbjzz2022-0959

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Objective To explore the oral sensory-motor function and its correlation with consonant pronunciation errors in children with functional articulation disorders (FAD), in order to provide basis and ideas for intervention in FAD children. Methods A total of 61 FAD children admitted to the Department of Child Health in Qingdao University Affiliated Hospital from June 2021 to January 2022 were selected as the case group, and 90 normal healthy children were enrolled into the control group. Speech disorder examination, articulatory organ, hearing examination and oral sensory-motor assessment were performed in children to analyze the correlation between consonant mispronunciation and oral sensory-motor function. Results Compared with those of control group, the total score of oral sensory-motor function (0.85±0.08 vs.0.94±0.03), oral sensation (0.96±0.08 vs.1.00±0.00), mandibular movement (0.80±0.15 vs.0.91±0.05), lip movement (0.86±0.09 vs.0.93±0.04) and tongue movement (0.82±0.12 vs.0.94±0.03) of children in the case group were significantly lower (t=10.307,4.471,6.595,5.865,9.626, P<0.001). There were correlations of bilabial and mid-lingual sounds with the movements of the tongue and jaw (P<0.05), and correlations between labiodental sounds and movements of jaw and lip part (P<0.05), between lingual and tongue part movements (P<0.05). Moreover, correlations ofprelingual, postlingual and lingual root sounds with jaw, tongue and lip part movements were significant (P<0.05). Conclusion Oral sensory-motor function in children with FAD is low, and is correlated with consonant mispronunciation to varying degrees.

Review

Review of diagnostic scales for the assessment of early neurodevelopment in infants and toddlers

HUANG Heng-ye, YU Guang-jun

2023, 31(2):  162-166.  DOI: 10.11852/zgetbjzz2022-0627

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Early infant and toddler development is a critical period in the life span of children, and preterm or high-risk infants are at a high risk of neurodevelopmental disorders. Therefore, early detection and intervention are of great importance to improve neurodevelopmental outcomes in infants and toddlers. This review summarizes common diagnostic scales for neurodevelopmental assessment of infants and toddlers in home and abroad, especially history of evolution, current status of application, advantages and disadvantages of Bayley Scales of Infant and Toddler Development, Gesell Development Schedules, Griffiths Mental Developmental Scales, and Chinese Children Development Scales, so as to provide a reference for pediatricians′ clinical work.

Research progress in clinical application of general movement assessment

SHEN Xiu-shu, WANG Jun

2023, 31(2):  167-170.  DOI: 10.11852/zgetbjzz2022-0242

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Infants with premature, brain injury are at a high risk of neurodevelopmental disorders. There are many options to evaluate the neurologic and developmental disability, among which a large number of studies have proved that general movement assessment is a reliable and effective assessment tool for the ultra-early prediction of neurodevelopmental disorders such as cerebral palsy. General movement assessment includes global general movement assessment and detailed general movement assessment. Global general movement assessment is a qualitative evaluation. Detailed general movement assessment quantifies the motion patterns according to general movement optimality score and motor optimality score, which is not only helpful to observe the changes in the developmental trajectory of the movements in infants and evaluate the effects of early intervention, but also beneficial to predict different neurodevelopmental outcomes more comprehensively and accurately.

Research progress in neurodevelopmental disorder caused by KIF5C gene mutation

CHEN Yi-ru, CHEN Wen-xiong

2023, 31(2):  171-175.  DOI: 10.11852/zgetbjzz2022-0476

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KIF5C gene is the candidate gene of neurodevelopmental disorder such as autism spectrum disorder(ASD). KIF5C gene encodes KIF5C kinesin, which helps to transport cargos required for neurite maturation along microtubules for a long distance, and is important for neuronal development. The structure of KIF5C kinesin includes the head motor domain, stalk dimerization domain and tail domain. The exonic region of head motor domain is a common region of gene mutation, and intron mutation is occasionally reported. The c.709G>A is a hot spot mutation site, causing p.glu237lys amino acid mutation. KIF5C gene mutation causes the common neurodevelopment disorder in children, including malformation of cortical dysplasia (MCD), microcephaly, epilepsy, development delay/intellectual disability, autism-like features and so on. The mechanism of neurodevelopmental disorder caused by KIF5C gene mutation is not clear yet,but it might affect the ability of head motor domain to hydrolyze ATP. It is important to study the pathogenic mechanism of KIF5C gene mutation and its novel therapeutic interventions in depth. KIF5C gene therapy needs further study.

Research progress of hyperhomocysteinemia in inducing neural tube defects

SHEN Fu-hui, YIN Li-qin, WANG Fan

2023, 31(2):  176-179.  DOI: 10.11852/zgetbjzz2022-1140

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Neural tube defects (NTDs) are one of the most common central nervous system defects in newborns. Neural plate development, neural plate shape, neural plate curling, and nerve fold fusion are the four stages of neural tube closure, where genetic and environmental risk factors are involved. Through oxidative stress, Ca²⁺ overload, and a decreased S-adenosyl methionine(SAM)/S-adenosylhomocysteine(SAH) ratio, hyperhomocysteinemia(HHcy) causes overall DNA hypomethylation in the embryo, which results in high expression of genes involved in neural tube closure through histone modifications, gene polymorphisms, and methionine synthetase(MTR), as well as the activation of related signaling pathways(such as the Wnt/β-catenin signaling pathway and the PI3K/AKT signaling pathway), impairing the proper development of the neural tube, upsetting the equilibrium between cell proliferation and apoptosis, ultimately resulting in NTDs. Using data from earlier studies, this review strengthens the correlation between HHcy and NTDs, offers a theoretical framework for clinical NTD diagnosis and prevention, and goes into greater detail about the aforementioned pathways and their connection to HHcy.

Progress in drug therapy for fragile X syndrome

MEI Lian-ni, HU Chun-chun, XU Qiong

2023, 31(2):  180-184.  DOI: 10.11852/zgetbjzz2022-0958

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Fragile X syndrome (FXS) is a neurodevelopmental disorder that is the most common inherited cause of intellectual disability(ID) and the most prevalent monogenic cause of autism spectrum disorder (ASD). FXS is characterized by cognitive deficits, special facial features, behavioral problems and other multi-system abnormalities. This review combs the drugs that regulate abnormal neurobiology of FXS, in order to provide integrative data of the efficacy and safety of drugs therapy in FXS treatment.

Clinical application of China Children′s Asthma Action Plan

LI Yu, ZHAO Jia-hong, KAN Xuan

2023, 31(2):  185-189.  DOI: 10.11852/zgetbjzz2022-0477

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Bronchial asthma is the most common chronic respiratory disease in childhood. Poor asthma control will increase the disease burden of asthma and affect the quality of life. China Children′s Asthma Action Plan (CCAAP) aims to improve the level of clinical control in children with asthma. Even though it has been proposed for 5 years, its clinical application is not ideal at present, and the execution of the plan is poor. In order to improve the use of CCAAP and give full play to its effectiveness, this paper reviews the background, content, clinical application and significance.

Meta Analysis

Meta-analysis of the risk factors for recurrent wheezing after bronchiolitis

WANG Xu, WANG Shu-ying, LI Li, ZOU Ying-xue

2023, 31(2):  190-194.  DOI: 10.11852/zgetbjzz2022-0313

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Objective To systematically analyze the risk factors of recurring wheezing after bronchiolitis, in order to provide reference for reducing wheezing. Methods CNKI, Wanfang Data, Chinese biomedical literature database, VIP, Web of science, PubMed, Cochrane and Embase were searched until November 2021. The Chinese search term included bronchiolitis, wheezing and risk factors, the English search terms were bronchiolitis, bronchiolitides, respiratory sound, wheezing, stridor and risk factors. Two researchers both read and evaluated the documents individually. Data was extracted by researchers using RevMan 5.3 software. Meta-analysis was then performed with RevMan5.3 software. Results Totally 13 studies were finally included, of which six studies were in Chinese and seven studies in English. Meta-analysis results showed that the main risk factors for recurrent wheezing after bronchiolitis included boys (OR=1.26,95%CI:1.04 - 1.54), a history of eczema (OR=2.68, 95%CI:2.02 - 3.56), personal history of allergy (OR=4.42, 95%CI:3.31 - 5.91), family history of asthma (OR=3.72, 95%CI: 2.38 - 5.83), family history of atopic disease (OR=2.75, 95%CI: 1.50 - 5.04) and tobacco exposure (OR=2.68, 95%CI:1.44-4.99),while breastfeeding was a protective factor (OR=0.47, 95%CI:0.23 - 0.96). Conclusions There are lots of risk factors for recurrent wheezing after bronchiolitis in children, among which the leading risk factor is personal history of allergy, followed by family history of asthma, family history of atopic disease, history of eczema, tobacco exposure, boys, while breastfeeding may reduce the prevalence of recurrent wheezing after bronchiolitis.

Clinical Research

Characteristics of neuropsychological development level in children with spinal muscular atrophy

PENG Xin-yue, XUE Yang, SHAN Ling, JIA Fei-yong, DU Lin

2023, 31(2):  195-199.  DOI: 10.11852/zgetbjzz2022-1262

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Objective To explore the characteristics of neuropsychological development in children with spinal muscular atrophy (SMA), so as to provide theoretical basis for promoting the overall development of SMA children and further enriching and improving the rehabilitation treatment plan for SMA children. Methods From January 2019 to August 2022, 16 children diagnosed with SMA in the Department of Developmental Behavior Pediatrics of the First Hospital of Jilin University were selected into SMA group, and 19 healthy children matched by age and gender were enrolled as the control group.The Griffiths Mental Development Scales-Chinese (GDS-C) was used to evaluate the developmental levels of the children, and the differences were analyzed between the two groups.HammerSmith Functional Motor Scale Expanded (HFMSE), the Children′s Hospital of Philadelphia Infant Test of Neuromuscular Disorders(CHOP INTEND) and Revised Upper Limb Module(RULM) were used to assess the motor function of SMA children. Results The development levels of motor (t=-27.592), personal-social(t=-7.485), hearing and language(t=-3.216), hand-eye coordination(t=-4.709), performance(t=-4.681) and reasoning(t=-2.468) in SMA children were significantly lower than those of the healthy control(P＜0.05).The development quotients of motor and personal-social in GDS-C were significantly correlated with age of SMA children(r=-0.625, -0.611, P＜0.05).The HFMSE score was positively correlated with motor(r=0.805), hand-eye coordination(r=0.503) and performance(r=0.590) development quotient in GDS-C(P＜0.05).CHOP INTEND score was positively correlated with motor(r=0.564), hand-eye coordination(r=0.587) and performance(r=0.759) development quotient in GDS-C(P＜0.05). RULM score was positively correlated with performance(r=0.643) development quotient in GDS-C(P＜0.05). Conclusion Compared with healthy children with the same age, SMA children have developmental delay in other areas apart from motor development.

Cranial morphological characteristics and influencing factors of plagiocephaly in infants

ZHANG Lei, HU Yao-fang, GE Yu-jia, DONG Jing, LIU Pan-ting, CHI Xia, TONG Mei-ling, QIAN Jun

2023, 31(2):  200-204.  DOI: 10.11852/zgetbjzz2022-0911

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Objective To investigate the cranial morphological characteristics and influencing factors of plagiocephaly in infants and children aged 3 to 18 months, so as to provide guidance and basis for the prevention and intervention of cranial anomalies in infants and children. Methods A total of 228 infants with plagiocephaly determined during physical examination in Nanjing Maternal and Child Health Hospital from January to December 2019 were selected as the case group, and 394 infants with normal skull shape were selected as the control group. Gender and age were matched between the two groups. The clinical characteristics of the case group were analyzed, and the influencing factors of plagiocephaly were analyzed by comparing the differences of basic information, maternal pregnancy and childbirth history, sleep posture and bone mineral density between the two groups. Results 1) The proportion of males in plagiocephaly group was higher than that of females. In term of age, the proportion of plagiocephaly in infants aged 6 months ± 7 days was the highest, then the proportion of plagiocephaly decreased with the increase of age. The detection rate of brachycephaly was the highest, and statistically significant difference in the type of cephalic malformations was found among different age (χ²=34.409) and severity(χ²=11.404) groups(P<0.05). 2) Univariate analysis showed that there were statistical differences in single/twin (χ²= 4.724), neonatal head injury history (χ²=8.430), sleep posture (χ²=23.881) and bone mineral density (t=2.771) between case group and control group (P<0.05). 3) Multivariate Logistic regression analysis showed that age(taking 3 months ± 7 days group as the reference, 6 months ± 7 days group OR=3.720, 95%CI:1.959 - 7.16, P<0.05; 8 months ± 7 days group OR =3.181, 95%CI:1.449 - 6.984, P<0.05; 12 months ± 7 days group OR=3.195, 95%CI:1.281 - 7.966, P <0.05) and twins (OR=3.950, 95%CI:1.227 - 12.717, P<0.05) were risk factors for plagiocephaly, while mixed sleeping posture (OR=0.209, 95%CI:0.129 - 0.338, P<0.05) and bone mineral density (OR=0.763, 95% CI:0.636 - 0.917, P<0.05) were protective factors of infant plagiocephaly. Conclusions Age, twins, sleep posture and bone density are important influencing factors of infant plagiocephaly. With the growth of infant age, the plagiocephaly may be improved, and further longitudinal research is still needed to verify the influencing factors of infant plagiocephaly.

Correlation of various laboratory indicators and the expression level of inflammatory factors with neurodevelopment of newborns

CAO Bing-bing, LIN Duo-hua, DU Pei-zhen, YAN Tao, CHENG Jian-ting

2023, 31(2):  205-209.  DOI: 10.11852/zgetbjzz2022-0820

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Objective To analyze the correlation of various laboratory indicators and the expression level of inflammatory factors with neurodevelopment of newborns, so as to provide scientific basis for further study. Methods From January 2020 to October 2021, a total of 33 premature infants with infection during pregnancy were selected as the infection group. Meanwhile, 33 premature infants with asphyxia during perinatal period were selected as the asphyxia group and 34 normal premature infants as the control group. Blood coagulation function, whole blood count, neutrophils, lymphocytes, inflammatory factors, nerve tissue protein S-100β protein, neuron specific enolase (NSE), matrix metalloproteinase (MMP)-2, MMP-9 and other indicators were detected at the first day after birth of preterm infants, and neurodevelopmental examination was performed. The relationship between the levels of these indicators and the neurodevelopment of premature infants was analyzed. Results Neonatal behavioral neurological assessment (NBNA) score and developmental quotient of children in the infection group and the asphyxia group were significantly lower than those in the control group (F=53.665, 16.468, P<0.001). The levels of serum IL-6, tumor necrosis factor-α (TNF-α), IL-1β, MMP-2, MMP-9, S-100β protein and NSE in the infection group and asphyxia group were significantly higher than those in the control group (F=58.265, 38.455, 61.490, 32.068, 67.366, 67.666, 64.436, P<0.001). The bivariate Pearson correlation coefficient analysis showed that the NBNA score (r=-0.594, -0.493, -0.632, -0.304, -0.633, -0.670, -0.569, P<0.001) and developmental quotient (r=-0.303, -0.291, -0.326, -0.472, -0.310, -0.349, -0.293, P<0.001) were negatively correlated serum levels of IL-6, TNF-α, IL-1β, MMP-2, MMP-9, S-100β protein and NSE. Conclusion Many laboratory indicators and inflammatory factors are related to the neurodevelopment of newborns, which may provide new ideas on early assessment of neurodevelopment and farther treatment for preterm infants.

Status quo and influencing factors of emotional behavior problems in children with epilepsy

YU Wei-hong, PAN Yue-rong, NIAN Shi-cui, YU Zu-lin

2023, 31(2):  210-214.  DOI: 10.11852/zgetbjzz2022-0853

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Objective To understand the status quo and influencing factors of emotional and behavioral problems in epileptic children and normal children, in order to provide clinical guidance for disease intervention. Methods A total of 192 cases of epileptic children admitted to the Department of Neurology of Anhui Children′s Hospital were selected from May 1st, to November 1st, 2021. Meanwhile, Students from four primary and middle schools in Hefei were selected matched by age and gender with the ratio of 1∶1. The parents of 384 children were surveyed by general information questionnaire and Strengths and Difficulties Questionnaire (SDQ) (parent version). Results The abnormal detection rate of total difficulty in epileptic children and normal children was 25.00% and 0.52%, respectively. Children with epilepsy had significantly higher scores of emotional symptoms (t=33.343), conduct problems (t=23.123), hyperactivity problems (t=19.499), peer communication problems (t=15.700), total difficulty scores (t=22.420) and lower score of prosocial behavior (t=14.402) than normal children (P<0.001). Multivariate analysis showed that the type of medication, medication compliance, the frequency of attacks, the medical insurance, the monthly family income, and the gender of the main caregiver were the factors influencing the emotional behavior in children with epilepsy (P＜0.05). Conclusions Children with epilepsy are more likely to have emotional and behavioral problems than normal children. Family members and medical staff should pay attention to it and urgently take intervention measures.

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Nutrition and physical development status of school-age children aged 10 to 12 years in rural Linxia Prefecture, Gansu

YIN Li-mei, WANG Yan-ling, ZHU Xiao-nan, ZHENG Jing, CAO Yong-qin, SUN Wei, FEI Xiu-lan, CHEN Guo-hua

2023, 31(2):  215-219.  DOI: 10.11852/zgetbjzz2022-0471

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Objective To investigate the physical development and nutrition status of rural school-age children in Linxia Hui Autonomous Prefecture, Gansu Province, so as to provide data support for improving children′s health in ethnic minority areas. Methods School children aged 10 to 12 years in Linxia Hui Autonomous Prefecture of Gansu Province in 2019 were selected in this cross-sectional survey. Height and weight of the participants were measured, then body mass index(BMI) was calculated. The detection rates of malnutrition, growth retardation, overweight and obesity were analyzed to assess children′s growth and development. Results The average weight was 33.3 kg and 31.7 kg for 10-year-old boys and girls in rural Linxia, which was 33.8 kg and 33.2 kg for 11-year-old boys and girls, 34.6 kg and 35.2 kg in 12-year-old boys and girls. The average height was 139.8 cm and 138.7 cm for 10-year-old boys and girls in rural Linxia, which was 141.1 cm and 141.7 cm for 11-year-old boys and girls, 143.2 cm and 143.8 cm in 12-year-old boys and girls. The detection rate of malnutrition was 35.1%(36.9% for boys and 33.0% for girls), including moderate malnutrition of 23.4%, mild malnutrition of 11.7%, overweight of 4.7% and obesity of 4.6%. There was no statistically significant difference in nutritional status among different gender and age groups(Z=368 213.0, H=0.132, P＞0.05). The growth retardation rate increased with age, and the overall rate was 5.8%(4.2% for boys and 7.4% for girls). There were significant differences in growth retardation rate(χ²=99.000, 198.000, P<0.001) and height(Z=346 398.0, H=150.97, P<0.05) among different gender and age groups. Conclusion The physical development level of rural school-age children in Linxia Prefecture, Gansu Province lags behind, so it is supposed to strengthen the growth and development of children, and take effective measures to promote the healthy development of children.

Effects of action observation therapy based on mirror neuron theory on the balance and walking ability of children with cerebral palsy

FAN Tao-lin, LIU Jie, HE Chen, TAN Ling-hui, LI You, XIAO Xi-hui, JIANG Can

2023, 31(2):  220-224.  DOI: 10.11852/zgetbjzz2022-0855

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Objective To investigate the effects of action observation therapy(AOT) based on mirror neuron theory on the balance and walking ability of children with cerebral palsy(CP), so as to provide clinical basis for improving the motor function of the lower extremities in CP children. Methods A total of 99 CP children who were treated in Xiangya Boai Rehabilitation Hospital from October 2021 to February 2022 were randomly divided into AOT group (n=50) and control group (n=49) according to the digital table method. Both groups of CP children received routine rehabilitation therapy. Additionally, children in AOT group received AOT for 40 minutes a day, where they watched the video with sports content first, and then performed the action. Children in the control group received therapy 40 minutes a day, watched the animated videos irrelevant to the content of the movement first, and then performed the same functional actions with the AOT group. Both groups received treatment for 12 weeks, once a day, 5 times per week. The balance function, walking ability and gross motor function were assessed before treatment and after 12 weeks of treatment using the Pediatric Balance Scale (PBS), 10-meter Maximum Walking Speed (10 m MWS) and Gross Motor Function Methods (GMFM). Results After 12 weeks of treatment, the scores of PBS, 10 m MWS, GMFM-D area and E area in the two groups were significantly higher than those before treatment (AOT group:t=34.156, 40.379, 18.569, 28.856; control group:t=14.342, 31.533, 11.058, 16.479, P<0.001). The scores of PBS (40.76±6.38), 10 m MWS(20.30±3.06), GMFM-D area (33.52±5.88) and GMFM-E area (46.44±13.37) in the AOT group were significantly higher than those in the control group after 12 weeks of treatment (t=2.245, 2.573, 2.345, 2.101, P<0.05). Conclusions Action observation therapy based on mirror neuron theory can effectively improve the balance function and walking ability of children with cerebral palsy,which is worthy of application in clinic practice.