Chinese Journal of Child Health Care

Expert consensus on the nurturing care specialty construction for infants and young children

Child Health Care Branch of Chinese Preventive Medicine Association, Special Committee on Prevention and Treatment of Autism of China Maternal and Child Health Research Association, Hubei Special Children Rehabilitation Association

2023, 31(8): 813-816. DOI: 10.11852/zgetbjzz2023-0543

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Infancy is a critical period for children's growth and development, and the provision of good nurturing care and health management at this stage will promote their all-round development in physical development, movement, language, cognition, emotion and sociality. Both the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) mentioned that the most direct and effective way to promote early childhood development is nurturing care. Based on this, the Child Health Care Branch of the Chinese Preventive Medicine Association led the establishment of an expert group to formulate this expert consensus in combination with the actual situation of child health care in China, in order to guide the construction of specialties in infants and young children nurturing care in health care institutions at all levels, improve caregivers' parenting and care skills, help create a good family environment, and ensure infants and young children's health, nutritional balance, life safety, emotional support and opportunities for early learning.

Strengthening the integration and development of nurturing care in children's health services

ZHANG Yue

2023, 31(8): 817-820. DOI: 10.11852/zgetbjzz2023-0720

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As an important content to promote early childhood development, nurturing care has received extensive attention from international and domestic communities. Multi-dimensional child rearing concepts and models play an important role in the healthy development of children. Child health service workers are the earliest and continuous contact with child caregivers. Incorporating the concept of parenting into children's health monitoring services can influence parents' knowledge, attitudes and behaviors, and better promote children's potential development. This article introduces the concept, connotation, evaluation and intervention of parenting for the reference of relevant personnel.

Necessity of establishing the early childhood development surveillance system in China

ZHANG Yunting, LU Chunling, WANG Haiwa, ZHAO Jin, JIANG Fan

2023, 31(8): 821-824. DOI: 10.11852/zgetbjzz2022-1513

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As an important component of the United Nations Sustainable Development Goals, the international community's attention to early childhood development continues to rise. Against the background of countries' active promotion of early childhood policies and large-scale population-based intervention programs, the assessment and monitoring of early childhood development need to be adequately recognized and emphasized. Based on the assessment and monitoring studies conducted at home and abroad, researchers should focus on the optimization of population-based assessment tools for early childhood development and localization in China, form a multidimensional risk factor-developmental outcome assessment system, establish a large-scale population-based cohort with population-based assessment goals, so as to provide necessary evidence for strategy formulation and policy design of early childhood development in China.

Development and evaluation of the Caregiver's Nurturing Care Practice Questionnaire for children aged 0 - 3 years

KONG Wenrui, XU Mengxue, JIA Ni, CHENG Tong, LI Qiuju, LIU Xin, WU Yan, FENG Chengyun, ZHU Zonghan, GUAN Hongyan

2023, 31(8): 825-830. DOI: 10.11852/zgetbjzz2023-0237

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Objective To develop the Caregiver's Nurturing Care Practice Questionnaire for children aged 0 - 3 years based on Chinese culture background, and to test its reliability and validity. Methods Through literature review and expert consensus, primary questionnaire was developed based on the nurturing care theory and Chinese infant and toddler nurturing culture.A pre-survey was conducted to screen items, then the final version of Caregiver's Nurturing Care Practice Questionnaire(C-NCPQ) was formed based on the expert workshop comments. A sample of 851 parents whose children were 0 - 3 years old were selected in this study to finish the questionnaire in order to test the reliability and validity of C-NCPQ. Data on Cronbach's α coefficient, split-half reliability and test-retest reliability were used to evaluate the reliability of the C-NCPQ. Validity evaluation was based on the construct validity and criteria validity, and the Index of Child Care Environment(ICCE) and the Child Home Nurture Environment Scale were used as criteria. Results C-NCPQ included 44 items in 6 dimensions, including nurturing pattern, healthcare, nutrition and feeding, responsive care, play experience and safety and security. The total Cronbach's α coefficient was 0.913, the Guttman split-half reliability coefficient was 0.853, and the correlation coefficient for the test-retest reliability was 0.745. The confirmatory factor analysis showed that six-dimension model fit well(χ²/df=2.77, RMSEA=0.046, CFI=0.833, TLI=0.819, SRMR=0.50). Factor load of each item was all ＞0.3(P＜0.001). The correlation coefficient between the ICCE and the C-NCPQ was 0.561, the correlation coefficients of C-NCPQ with Child Home Nurture Environment Scales for children aged 0 - 1 and 1 - 3 years were 0.406 and 0.600, respectively. Conclusions C-NCPQ is a simple and easy questionnaire with proven reliability and validity, which can be used to assess and guide nurturing care practices of families with infants and toddlers at the grassroots level.

Association between temperament and body mass index two years later in preschool children based on China Family Panel Studies

XIAO Wucai, CHEN Jing, SHAN Rui, GUO Yawei, LIU Zheng

2023, 31(8): 831-835. DOI: 10.11852/zgetbjzz2023-0032

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Objective To investigate the association between temperament and body mass index (BMI) in children, in order to provide scientific basis for designing individualized obesity intervention measures based on temperament of children in the future. Methods In the China Family Panel Studies (CFPS) database, 1 385 children who participated in the temperament questionnaire survey of children aged 1 to 3 in 2016 and had completed height and weight information in the survey in 2018 were selected as study subjects. Multiple linear regression models were used to analyze the association between scores on five temperament dimensions (activity, social inhibition, reactivity, emotionality and preoccupation) and BMI in children two years later. Results After adjusting for children's age, sex, region, baseline BMI, parental education level and depression, each one-point increase in childhood activity score was associated with a lower BMI by 0.6% two years later (95%CI: 0.004% - 1.2%, P=0.048). For every one-point increase in social inhibition scores, BMI was lower by 0.7% two years later (95% CI: 0.2% - 1.3%, P=0.013). The association did not differ between subgroups (P_interaction>0.05). The associations of early childhood reactivity, emotional and focus scores with preschool BMI were not observed (P>0.05). Conclusions Higher activity and social inhibition in children of 1 to 3 years old are associated with lower BMI in early school age. The results of this study provide preliminary scientific basis for designing individualized obesity intervention measures based on temperament of children in the future.

Follow-up study on the modifiable predictors for outdoor after-school activities, screen time and sleep duration in Chinese preschoolers

YE Sunyue, WANG Haitang

2023, 31(8): 836-840. DOI: 10.11852/zgetbjzz2022-1307

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Objective To explore the modifiable determinants of the lack of outdoor after-school activities, prolonged screen time and insufficient sleep duration in preschoolers, in order to provide scientific reference for health education and intervention. Method From September 2020 to September 2021, a total of 819 parents of preschool children (3-6 years old) were recruited in this study and were investigated twice by 1-year interval, and the longitudinal data were statistically analyzed by multivariate Logistic regression model. Results Insufficient outdoor activities, prolonged screen time and insufficient sleep duration of preschool-aged children were correlated with their baseline levels (χ²=4.68,19.74,8.74,P<0.001). The maternal screen time (OR=2.01,95%CI:1.36 - 2.99) and screen accessibility (OR=1.62,95%CI:1.14 - 2.31) at baseline were correlated with the follow-up screen time of preschool-aged children. Lack of maternal outdoor activities (OR=2.17,95%CI:1.48 - 3.18) and fewer outdoor venues (OR=1.55,95%CI:1.11 - 2.17) at baseline were associated with the follow-up insufficient outdoor activities in preschoolers. Insufficient outdoor activities (OR=1.42,95%CI:1.01 - 1.99) and non-maternal caregivers of preschoolers (OR=1.63,95%CI:1.16 - 2.30) at baseline were related to the lack of sleep duration in preschoolers. Conclusions Adverse maternal behaviors, poor home-based physical environments and caregivers who are not mothers are the modifiable determinants of insufficient outdoor after-school activities, prolonged screen time and insufficient sleep duration in preschool children.

Characteristics and influencing factors of auditory processing ability among 1 234 preschool children in Nanjing

SUN Yuying, LIU Panting, ZHU Huiqin, LIN Huanxi, XIAO Zhenglu, YU Xinyue, CHI Xia, HONG Qin

2023, 31(8): 841-845. DOI: 10.11852/zgetbjzz2022-1318

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Objective To investigate the characteristics and influencing factors of auditory processing development in preschool children aged 3 - 6 years in Nanjing, so as to provide clues for improving the auditory processing ability of preschool children. Methods A total of 1 311 children aged 3 - 6 years from 4 kindergartens in Nanjing were selected by stratified cluster random sampling from June to July 2021. The characteristics and influencing factors of children's auditory processing were investigated and analyzed with the self-designed basic information questionnaire and the Preschool Auditory Processing Assessment Scale. Results A total of 1 234 valid questionnaires were collected. The total score of Preschool Auditory Processing Assessment Scale for boys and girls was 49.01±12.70 and 47.26±12.16, respectively, and the difference was statistically significant (t=2.469, P<0.05). With the increase of age, the total score of auditory processing scale gradually decreased, and the difference was statistically significant (F=2.909, P<0.05). Multivariate linear regression analysis showed that gender (β=-1.169), age (β=-0.976), with other neurodevelopmental disorders (β=-10.849) and daily screen time (β=1.432) were main influencing factors for auditory processing abnormalities (P<0.05). In detail, boys, younger age, neurodevelopmental disorders and longer screen time were associated with a higher risk for auditory processing abnormalities. Conclusions Children's auditory processing ability is affected by gender, age, neurodevelopmental disorders and screen time. Attention to the development of auditory processing in preschool children should be raised, with early identification of auditory processing abnormalities and effective medical intervention.

Correlation analysis of sleep disorder and family function in children with asthma

LI Zhenzhen, LI Shiyi, YU Liping, ZHAO Lin, HAN Chunfang

2023, 31(8): 846-850. DOI: 10.11852/zgetbjzz2022-1021

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Objective To investigate the current situation of sleep disorder and family function in children with asthma, and to explore the correlation between family function and sleep disorder of children with asthma, so as to provide basis for the prevention and treatment of sleep disorder in children with asthma. Methods Using convenience sampling method, 256 asthmatic children aged 6 - 11 years who were treated in the outpatient department and inpatient treatment in Weifang People's Hospital during December 2019 to October 2020 were selected as participants. The general information questionnaire, General Function Sub-Scale of McMaster Family Assessment Device (GF-FAD) and Sleep Disturbance Scale for Children (SDSC) were used for investigation. Results The average score of GF-FAD in 256 asthmatic children was 29.80±5.56, the average score of SDSC was 37.54±5.30. A total of 93 (36.33%) asthmatic children were detected with sleep disorder. The GF-FAD score of children with asthma were positively correlated with GF-FAD score (r=0.373, P<0.001). Stratified regression analysis showed that academic performance (β=0.232, P<0.001), limited physical activity (β=0.193, P=0.001), family function (β=0.285, P<0.001) were important influencing factors of sleep disorder in children with asthma. Conclusions The current situation of sleep disorder in children with asthma needs to be improved in this area, and family function is an important influencing factor of sleep disorder. The medical staff should pay more attention to the improvement of family function, and to improve their sleep quality, thereby promoting the growth and development of children with asthma.

Effects of hypoxic preconditioning of hDPSCs on autophagy and ATG7 in brain neurons of neonatal HIBD rats

GAO Shujun, ZHANG Hao, WU Muyang, ZHANG Xinyue, XIAO Peilun, WANG Xiaoli, WANG Fantao

2023, 31(8): 851-857. DOI: 10.11852/zgetbjzz2022-1261

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Objective To analyze the effects of hypoxic preconditioning of human dental pulp stem cells (hDPSCs) on autophagy and autophagy related geneATG7 in brain neurons of neonatal rats with hypoxic-ischemic brain injury (HIBD), so as to provide scientific theoretical basis for the clinical application of hDPSCs. Methods From January 2021 to September 2022, totally 72 seven-day-old SD rats were randomly divided into sham operation group (Sham group), HIBD group, normoxia preconditioning hDPSCs group (N-hDPSCs group) and hypoxia preconditioning hDPSCs group (H-hDPSCs group).The HIBD model of neonatal rats was prepared by Rice Vannuis method.N-hDPSCs and H-hDPSCs were transplanted into the lateral ventricle 24 hours after the HIBD model established.Twenty-four hours after transplantation, the effects of hypoxic preconditioning with hDPSCs on autophagy in the injured cerebral cortex neurons of HIBD neonatal rats were detected by immunofluorescence double staining combined with Western Blots.Four days after transplantation, hematoxylin and eosin stain (HE) and Nissl stain were used to observe the pathological changes of cerebral cortex on the injured side of neonatal rats in each group. Results The results of immunofluorescence staining showed that thenumberof LC3-Ⅱ, Beclin-1, and ATG7 positive cells in cerebral cortex neurons of H-hDPSCs group and N-hDPSCs group were significantly lower than those of HIBD group, and these expression of H-hDPSCs group was significantly lower than those of N-hDPSCs group (F=326.87, 205.87, 229.59, P<0.05).The number of P62 positive cells in cerebral cortex neurons of H-hDPSCs group and N-hDPSCs group was significantly higher than that of HIBD group, and P62 expression of H-hDPSCs group was significantly higher than that of N-hDPSCs group (F=124.07, P<0.05).Western blots showed that the expression levels of LC3-Ⅱ and Beclin-1 protein in cerebral cortex neurons of H-hDPSCs group and N-hDPSCs group were significantly lower than those of HIBD group, and H-hDPSCs group was significantly lower than that of N-hDPSCs group (F=46.949, 43.330, P<0.05).HE staining results showed that neurons in cerebral cortex of HIBD group were irregular in shape and arrangement, while the neurons in the cerebral cortex of N-hDPSCs group and H-hDPSCs group had regular morphology and orderly arrangement.The results of Nissl staining showed that the number of neurons in the cerebral cortex of N-hDPSCs group and H-hDPSCs group was more than that of HIBD group, and the number of neurons in H-hDPSCs group was significantly more than that in N-hDPSCs group (F=312.44, P<0.05). Conclusions Transplantation of hDPSCs can downregulate the expression of autophagy related proteins Beclin-1, LC3-Ⅱ, ATG7, and upregulate the expression of P62 in brain neurons of neonatal rats with HIBD, so as to inhibit autophagy, reduce HIBD in neonatal rats and promote the repair of brain damage.Among them, hypoxic preconditioning of hDPSCs is more effective.

Chinese Early Human Capacity Index and norm

ZHAO Jin, ZHANG Yunting, SONG Yingquan, JIANG Fan

2023, 31(8): 858-863. DOI: 10.11852/zgetbjzz2022-1514

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The lack of population-based assessment tools is an important bottleneck problem that restricts the clinical work of early childhood development in the maternal and child health care in China. After localization, the Early Human Capacity Index, a population-based assessment tool of early childhood development for children aged 3 to 6 years, has completed the reliability and validity test and established Chinese norm, developing the Chinese Early Human Capacity Index (CheHCI). The scale can discriminate children by children's developmental level based on sex, parental education, family income and nutrition status. The tool has been widely used in Qinghai Province, Yunnan Province, Guizhou Province, Hebei Province, Henan Province, Xinjiang Uygur Autonomous Region, Shanghai City, Zhejiang Province and other areas where early development projects were carried out. It enables and promotes the surveillance and intervention program of early childhood development in China.

Research progress on the influence of family nurturing environment on the development of preschool children with attention-deficit hyperactivity disorder

WANG Yinuo, XU Yuying, ZHANG Xi, AN Zifen, YU Liping

2023, 31(8): 864-867. DOI: 10.11852/zgetbjzz2022-1516

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Attention-deficit hyperactivity disorder(ADHD) is a common chronic neurodevelopmental disorder in childhood, with inattention, impulsivity as the main symptoms in the preschool period, work, social and life disorders in adulthood, causing a heavy burden to families and society. In recent years, numbers of studies have shown a certain correlation between family nurturing environment and ADHD, a good family nurturing environment can improve some of the core symptoms of ADHD and promote the early comprehensive development of preschoolers. The paper systematically reviews the related influence, intervention practice regarding the relationship between family nurturing environment and ADHD based on the preschool ADHD concepts, so as to provide basis for the continuous optimization of family foster care system and preschoolers with ADHD care work in China.

Research progress in the effects of breast milk on T cell immune function in early life

ZHU Simin, ZHANG Wenting, TU Wenjuan

2023, 31(8): 868-872. DOI: 10.11852/zgetbjzz2022-1152

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Different from adult, the immune systems of infants are not yet mature.Breast milk is a key condition for the maturation of immune function early in life, because that bioactive components in breast milk can not only directly promote the development of T cell immune function but also affect it indirectly by promoting the colonization of intestinal flora.As a result, the infection of pathogens and excessive inflammation damage to the body would be reduced.This review mainly summarizes the effects of breast milk on T cell immune function in early life, aiming to raise awareness of the importance of breast milk and to promote breastfeeding.

Progress in the relationship between meteorological factors and asthma in children

LI Yumin, ZHANG Yuling, LIANG Xiaoping

2023, 31(8): 873-878. DOI: 10.11852/zgetbjzz2022-1144

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Asthma is a relatively common chronic airway disease in the world, and is most prevalent in children. The current global climate change is unpredictable, and a large number of epidemiological studies and experimental studies have shown that the change of climate factors may cause the attack and/or aggravation of asthma in children. Climate factors can act on children with asthma through a variety of ways, mainly by affecting air pollutants or allergies to further play a role in asthma. The mechanism of action mainly includes airway inflammation, airway hyperresponsiveness, oxidative stress, lung function decline, etc. This review summarizes the relationship between meteorological factors and asthma in childhood.

Neuroimaging advances in the effects of exercise interventions on brain executive function inchildren with attention deficit hyperactivity disorder

KONG Dehua, ZHANG Gong

2023, 31(8): 879-883. DOI: 10.11852/zgetbjzz2022-1475

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Attention deficit and hyperactivity disorder(ADHD) is a common neuropsychological disorder in children, which is mainly manifested by defects in executive function such as inhibition, refresh, and conversion. Many studies have shown that exercise intervention, as an emerging treatment modality, can replace medication and psycho-behavioral interventions, and have a positive effect on ADHD children, improving their executive functions such as refreshment, conversion and inhibition. Functional magnetic resonance imaging(fMRI) and event-related potentials(ERP), two commonly used neuroimaging techniques, are important methods for studying ADHD in the completion of various cognitive processing activities and for comparing differences in brain regions and potentials. It has been shown that exercise interventions can activate brain areas closely related to executive functions such as the frontal lobe, bilateral parietal lobe, temporal lobe, hippocampus and cerebellum in ADHD children, effectively improving the latency and amplitude of the N2 and P3 components of the ERP in ADHD children, promoting the improvement of executive functions in ADHD children and consequently improving their clinical symptoms such as cognitive performance, memory, learning difficulties and emotional abnormalities. Both fMRI and ERP techniques have their own drawbacks and shortcomings. In future research, multimodal neuroimaging studies and emerging technologies can be used to improve the diagnosis and intervention of brain dysfunction in children with ADHD, to investigate and intervene on the neurophysiological mechanisms of children with ADHD as a whole, and to further explore the etiology and intervention methods of ADHD.

Correlation between home rearing environment and screen exposure in children aged 1 - 3 years

XU Yuying, WANG Xueqin, LUO Sha, ZHU Zijun, YU Liping, LI Dan

2023, 31(8): 884-888. DOI: 10.11852/zgetbjzz2023-0356

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Objective To analyze the correlation between home rearing environment and electronicscreen exposure of children aged 1 - 3 years, in order to providescientific basic for reducing early screen exposureand building a good family rearing environment. Methods A total of 208 children who were followed up in the Children's Healthcare Clinic of Wuchang Maternal and Child Health Hospital from July to December 2022 were selected into this study. A self-designed questionnaire and the "1 - 3 Years Child Home Nurture Environment Scale" were usedas research tools to investigate the screen exposure time and family rearing environment of children aged 1 to 3. Children's parents or caregivers were supervised and guided by doctors to complete the questionnaires. Results A total of 206 valid questionnaires were obtained, including 110 males(53.4%) and 96 females(46.6%). Children were(26.09±6.21) months old on average. Among 206 children, 57.28% were exposed to more than two types of screen products, with an average age of 17.4 months old.Infants' gender(Z=4.164), age(H=10.619), whether they were an only child(Z=6.190), whether they had independent electronic devices(Z=8.820), mother's literacy(H=6.697), father's literacy(H=9.155), and home parenting environment(H=6.920) were statistically significant for the difference in daily screen exposure time for infants and toddlers(P<0.05). Average screen time was negatively correlated with the total score of family rearing environment(r=-0.167, P<0.05). Conclusions Screen exposure is common in children aged 1 - 3 years, and there is a negative correlation between screen exposure and family rearing environment. A positive family nurturing environment should be built to enhance the quality and quantity of parent-child interaction and reduce electronic screen exposure to promote early childhood development.

Genetic characteristics of 58 children with unexplained developmental delay/intellectual disability analyzed by Trios-WES

FENG Jincai, ZHAO Tingting, JIA Jia, TIAN Yuan, SHAO Da, YU Guangjun

2023, 31(8): 889-894. DOI: 10.11852/zgetbjzz2022-1361

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Objective To improve diagnostic accuracy of developmental delay/intellectual disability (DD/ID) using genetic variation analysis of single nucleotide variant (SNV)/small insertion-deletion (InDel) and copy number variant (CNV) based on Trios-whole-exome sequencing (Trios-WES). Methods From March 1st, 2017 to March 31st, 2019, 58 children with DD/ID were enrolled and analyzed by Trios-WES technique, who were treated in the High-Risk Infants Multi-Disciplinary Treatment Outpatient and Rehabilitation Department Outpatient of Shanghai Children's Hospital, and were assessed by Gesell, WPPIS-Ⅳ or WISC-Ⅳ as non-external factors, negative by conventional genetic tests, and with unexplained reasons. Further phenotypic confirmation and Sanger sequencing verification were performed to analyze the results. Results Among 58 unknown-cause children with DD/ID, 41 DD/ID related gene variants were identified by Trios-WES analysis and 13 genes variants were reported for the first time. Thirty-threegenes variants (33/58, 56.9%) were found to be pathogenic single genes or multiple gene variants, including three CNV variants and one paternal uniparental disomy (UPD). There were 10 missense variants, 7 splicing variants, 7 frameshift variants and 5 nonsense variants. The de novo variants accounted for 79% of all pathogenic variants. Among them, MECP2, TCF4, SYNGAP1, UBE3A and SHANK3 gene variants appeared frequently. Conclusions The clinical genetic testing strategy of Trios-WES analysis can improve the diagnosis rate of children with unexplained DD/ID, help to identify the cause, and provide a basis for further treatment and genetic counseling.

Prevalence of prenatal depression in pregnant women and its effect on the occurrence of small for gestational age infants

XING Jingjing

2023, 31(8): 895-898. DOI: 10.11852/zgetbjzz2022-1045

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Objective To explore the prevalence of prenatal depression in pregnant women and its impact on the occurrence of small for gestational age (SGA), in order to provide evidence for the good prognosis of mothers and infants. Methods A total of 537 pregnant women admitted to Daxing District People's Hospital from June 2017 to June 2019 were included in the study. The Edinburgh Postnatal Depression Scale (EPDS) was used to evaluate the depressive symptoms. According to EPDS result, the participants were divided into depression group and control group. The general information, delivery outcome, newborn weight, head circumference, chest circumference and body lengthwere compared between the two groups, so as to determine the impact of depression on SGA. Results There were 106 pregnant women in the depression group, with a prenatal prevalence rate of 19.74%. The EPDS score of the depression group was significantly higher than that of the control group (t=24.234, P＜0.001), and the age was significantly lower than that of the control group (t=2.480, P=0.013). In the depression group, the gestational age of infants was significantly smaller than that of the control group (t=2.398, P=0.017), the weight, head circumference, chest circumference and body length of the newborns were significantly lower than those of the control group (t=4.862, 4.775, 9.301, 10.758, P＜0.001), and the proportions of premature delivery(χ²=4.758) and SGA(χ²=6.803) of the newborns were significantly higher than those of the control group. Logistic regression analysis showed that antenatal depression (OR=1.802, 95%CI:1.232 - 4.793, P=0.016) was an independent risk factor for SGA. The receiver operating characteristic curve (ROC curve) analysis showed that the area under the curve of SGA predicted by the EPDS score of 12 was 0.757. Conclusions Prenatal depression is highly prevalent in pregnant women, impacts fetal development and is an independent risk factor for SGA. Pregnant women should be screened for antenatal depression at an early stage, and those with depressive symptoms should be offered timely psychological support and intervention to promote maternal and infant health.

Clinical characteristics and prognosis of fine motor function in 108 children with hemiplegia

CHEN Yi, YUN Guojun, WANG Jinggang, ZHOU Chunming, ZHANG Weiyun, GAO Li, CAO Jianguo

2023, 31(8): 899-903. DOI: 10.11852/zgetbjzz2022-0918

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Objective To analyze the clinical characteristics and the influencing factors of prognosis of fine motor function in 108 children with hemiplegia, so as to provide reference for scientific management of children with hemiplegia. Methods The clinical data of 108 children with hemiplegia hospitalized in Shenzhen Children's Hospital from June 2017 to December 2021 were retrospectively analyzed, and the influencing factors of prognosis of fine motor function in children with hemiplegia were analyzed. Results Among the 108 children with hemiplegia, there were 23 cases (21.3%) caused by prenatal and perinatal factors, 85 cases (78.7%) caused by postpartum injuries, including 33 cases (30.6%) caused by brain trauma. The hemiplegia diagnosed in 1 to 4 years old and 4 to 7 years old was mainly caused by traumatic brain injury (37.7%, 23/61), followed by stroke (21.3%, 13/61). Cognitive impairment negatively affected Fine Motor Function Measure (FMFM) score (β=-0.25, P<0.05), while diagnosis age positively affected FMFM score (β=0.449, P<0.001). Conclusions Among the causes of hemiplegia injury in children, postpartum acquired factors account for a large proportion, and brain trauma is the main cause. Cognitive dysfunction and age of diagnosis are the influencing factors of fine motor function score.

Relationship between MP-IgG and lipid metabolism in children

YAN Sangsang, ZHANG Jingxia, XU Meimei, WANG Guizhi, ZHU Tang, HAN Lihong

2023, 31(8): 904-908. DOI: 10.11852/zgetbjzz2022-0606

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Objective To investigate the relationship between Mycoplasma pneumonia (MP) infection and hyperlipidemia in children, in order to provide better guidance for the prevention and treatment of MP infection in children. Methods Serum specimens were collected from 472 children who took routine physical examinations in pediatric outpatient clinic from October 2020 to January 2021.MP-IgG and lipid metabolism indicators, including triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA), apolipoprotein Protein B (ApoB), was detected separately. Results The levels of TC and LDL-C in theMP-IgG positivegroup were higher than those in the MP-IgG negative group (Z=-2.746,-2.510, P＜0.05).The proportion of hypercholesterolemia in the MP-IgG positive group was significantly higher than that in theMP-IgG negative group (χ²=5.984, P=0.014).There was a statistically linear trend, also named a dose-response relationship, between MP-IgG grades and TC grades/LDL-C grades (χ²=12.704, 9.731, P＜0.05).Both Spearman correlation test and Kendall'tau b correlation test showed that MP-IgG was positively correlated with TC and LDL-C(P<0.05).Multi-class Logistic regression analysis showed that hypercholesterolemia may be an important factor affecting MP infection in children.The probability of MP-IgG positive in children with hypercholesterolemia was 2.865(95%CI:1.202 - 6.832) times that in children with normal TC. Conclusions There is a correlation between MP infection in children and hyperlipidemia.Appropriately reduction in cholesterol level may be beneficial to prevent and treat MP infection in children.

Clinical and cytogenetic study on two patients of Turner Syndrome with small supernumerary marker chromosomes

WU Qiong, KONG Hui, CHEN Jing

2023, 31(8): 909-912. DOI: 10.11852/zgetbjzz2022-0315

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Objective To study the clinical genetics of 2 patients of Turner's syndrome (TS) carrying small supernumerary marker chromosomes (sSMC), and to explore the role of sex determining region of Y chromosome (SRY) in genotype-phenotype of TS patients. Method Cytogenetics and fluorescence in situ hybridization (FISH) were used to detect 2 TS patients with sSMC. Results sSMC of case 1 was identified as pseudoequiarm double centromeres Y with karyotype 45,X[89]/46,X, +mar[11].ish psu dic(Y)(q11.23)(SRY++,DYZ3++). Case 2 sSMC was a rare ring X with karyotype 45, X [22]/46,X.ishr(X)(p11.1q13)(DXZ1+,SRY-),rev ish dim(X) (p11.2p22.3), dim (q21q28) [8]. Conclusions The origin and composition of sSMC can be accurately identified by cytogenetics and FISH. Whether SRY is positive or not is important for phenotype and prognosis of TS patients carrying sSMC.

WHO-CST intervention for children with autism spectrum disorders aged 2 to 9 years in China

CHEN Biyuan, ZOU Xiaobing, KE Xiaoyan, LIANG Fengjing, XIAO Xiang, YOU Cong, CHEN Kaiyun, DENG Hongzhu

2023, 31(8): 913-919. DOI: 10.11852/zgetbjzz2023-0033

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Objective To explore the effectiveness and feasibility of the WHO Caregiver Skills Training (CST) program for children with autism spectrum disorder(ASD) within the domestic community healthcare framework. Methods This study is a randomized, parallel-controlled intervention trial using the WHO-CST program training and supervision framework through the pathway of "professional-nonprofessional-caregivers-children with ASD" to deliver evidence-based intervention strategies to caregivers of ASD children. The training is conducted and supervised by certified master trainers from the Third Affiliated Hospital of Sun Yat-Sen University and Nanjing Brain Hospital. Results The primary outcomes included target problem behavior management, engagement improvement and engagement severity changes and joint-engagement rating. Additionally,preliminary outcomes of overall child participation, ASD symptom severity measurement, caregiver knowledge and skills, parent's sense of competence, family empowerment, stigma, and caregiver coping skills in adverse events will be provided. Conclusions This study is the first large-sample randomized controlled trial (RCT) to implement CST for ASD children in mainland China. The effectiveness and feasibility data will be obtained to provide evidence for promoting CST implementation.

Congenital lipoid adrenocortical hyperplasia caused by a new STAR gene mutation:A case report

LIU Yuting, LI Guangxu, PAN Xiang

2023, 31(8): 920-923. DOI: 10.11852/zgetbjzz2023-0092

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