Table of Content

10 April 2014, Volume 22 Issue 4

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Current status on child essential immunization coverage in rural western and central China.

JIANG Zhen, JU Li-rong, WANG Zhi-feng, ZHANG Hui, ZHANG You-ran, LUO Da-sheng, GUO Yan.

2014, 22(4):  343-346.  DOI: 10.11852/zgetbjzz2014-22-04-03

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Objective To investigate the current status of child immunization during 2008-2012 in rural western and central China. Methods Gansu, Guizhou, Guangxi and Shaanxi were selected as the investigated provinces.Maternal and child health intervention coverage questionnaire developed according to the maternal and child death predictive software LiST(the Lives Saved Tool) was applied in the one-time cross-sectional investigation. Results Bacille Calmette-Guéri(BCG) vaccine coverage rate was the highest in 2012, which reached to 99% in the investigated regions, followed by the measles vaccine, all above 95%.Polio vaccine, diphtheriatetanus and pertussis (DPT) vaccine, Hepatitis B vaccine coverage rates were around 80%.National unplanned vaccines such as flu bloodthirsty bacillus vaccine, pneumococcal vaccine, rotavirus vaccine rates were all lower than 10%.The eligible-age child vaccination rates for BCG vaccine, measles vaccine, Hepatitis B vaccine among children born in 2012 in investigated region were 96.4%, 89.4%, 79.3% respectively, while the other eligible-age child vaccination rates were all lower than 60%. Conclusions Improving eligible vaccination rate should be taken as an important indicator in evaluating the quality of rural immunization.Children from minority, lower education family and with younger parents should be received higher attention.Concerning the confirmed effects of haemophilus influenzae type B vaccine and pneumococcal vaccine, whether those will be included into national immunization planning framework needs future program verification.

Body mass index values for newborns according to gestational age.

SONG Pei-ge, PAN Ying, WU Ming-hui, AN Lin, PANG Ru-yan.

2014, 22(4):  347-349.  DOI: 10.11852/zgetbjzz2014-22-04-04

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Objective To establish population-based body mass index (BMI) centiles for gestational age specific newborns. Methods All the newborns born in Shunyi District Hospital and Shunyi Maternal and Child Hospital during 1 November 2009 to 21 January 2011 were taken standard measurement of birth weight and length.The newborns meeting the criteria were selected to create database.K-median-coefficent of variation method was used to smooth the percentile curves.Comparison was made with a Brazil's research. Results Percentiles at P₃, P₁₀, P₂₅, P₅₀, P₇₅, P₉₀, P₉₃ of BMI were calculated, the curves for each gestational age were successfully smoothed.Differences of BMI between genders were not statistically significant.The BMI values for gestational age in all percentiles showed a steady increase up to 38 weeks, levels off up to the 40^th week, followed by a slight decrease to the 42^nd week in both genders. Conclusion Recent percentiles for gestational age specific BMI of newborns are presented in this research, and it can be used as a BMI normative reference for the local clinicians.

Interaction effects of grandparent asthma status and passive smoking on asthma and asthma related symptoms among children.

MA Ya-nan, ZHAO Yang, LIU Yu-qin, HUANG Mei-meng, SUN Jing, LIU Yang, REN Wan-hui, LV Xue-feng, HE Qin-cheng, DONG Guang-hui.

2014, 22(4):  350-353.  DOI: 10.11852/zgetbjzz2014-22-04-05

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Objective To evaluate the interaction effects of grandparent asthma status and passive smoking on children asthma and asthma related symptoms. Methods Using a cluster random sampling method, 2 elementary schools and 1 kindergarten were randomly selected from seven cities of Liaoning province.All children lived with grandparent for more than 3 years from the selected schools were recruited in this survey.The information about the children's respiratory diseases, grandparent asthma status, living environment and enviromental tobacco smoke (ETS) exposure were collected by an international standard questionnaire from American Thoracic Society.The generalized linear mixed models (GLMMs) were applied to explore the interaction effects of grandparent asthma status and passive smoking on asthma and asthma related symptoms (persistent cough, persistent phlegm, current wheeze and allergic rhinitis). Results A total of 3 576 children involved in this survey.There were 224 children with grandparent asthma status and 970 children with ETS.The percentage of children with grandparent asthma status was 6.26% and 13.39% with ETS exposure.The prevalence of cough, current wheeze and asthma were 16.07%(336/224), 14.29%(32/224) and 13.39%(30/224) in children with grandparent asthma status, while that in children without grandparents asthma status were 10.32%(346/3 352), 5.91%(198/3 352) and 5.61%(188/3 352) respectively.Compared to the children without grandparent asthma status, the children with grandparent asthma status had higher risk of cough(OR=1.66, 95%CI:1.15～2.42), current wheeze(OR=2.65, 95%CI:1.78～3.96) and asthma(OR=2.60, 95%CI:1.72～3.93).The prevalence of cough and expectoration in children with ETS were 14.02%(136/970) and 6.19%(60/970) respectively.The children with ETS increased the risk of cough(OR=1.56, 95%CI:1.25～1.96) and expectoration(OR=1.57, 95%CI:1.13～2.18) compared with the children without ETS.GLMMs analysis showed there were significant interaction effects between grandparent asthma status and passive smoking. Conclusion Grandparent asthma status may increase the detrimental effects of passive smoking on asthma and asthma related symptoms in children.

Research on the negative life events of rural left-behind children and its influence on health risk behavior.

LIU Xian-hua, HU Yi-qiu, SUN Huan-liang, YAN Liang-shi.

2014, 22(4):  354-357.  DOI: 10.11852/zgetbjzz2014-22-04-06

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Objective To explore the negative life events of rural left-behind children and its relationship with health risk behavior. Method A total of 310 children, including 178 rural left-behind children and 132 rural non-left-behind children were surveyed by the Adolescent Self-Rating Life Events Check List (ASLEC) and the Adolescent Health Related Risky Behavior Inventory (AHRBI). Results 1) The rural left-behind children reported significantly more scores of negative life events in interpersonal relationship (F=12.695, P<0.001), punishment (F=8.306, P<0.01), loss (F=19.256, P<0.001)and health adaption (F=9.138, P<0.01), compared to rural non-left-behind children.2) Negative life events of rural left-behind children could predict 24% variance of their health risk behavior.The structural equation modeling fitting analysis was carried out:RMSEA=0.067, GFI=0.936, IFI=0.965, PGFI=0.579. Conclusion The rural left-behind children are the susceptible population of negative life events.Negative life event is an important risk factor of health risk behavior of rural left-behind children.

Developmental profile of children with autism spectrum disorder on PEP-3.

PENG Yang-hua, JING Jin, YE Xiao-fang, HUANG Zhe-lan, CHEN Xue-bin.

2014, 22(4):  358-360.  DOI: 10.11852/zgetbjzz2014-22-04-07

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Objective To explore the developmental profile of children with autism spectrum disorder (ASD) on PEP-3. Methods A total of 52 children with ASD who were divided into two groups according their intelligence level, low-function autism (LFA) and high-functioning autism (HFA), and 26 aged-matched typically children were evaluated by PEP-3 (each group included 23 boys and 3 girls, aged 2~5 years old). Results LFA children exhibited a greater developmental delay in all subtests on PEP-3 as compared with typically children (P<0.001).The scores and developmental ages on the cognitive verbal/preverbal (CVP) and gross motor (GM) subtests were lower in HFA group than TD group (P<0.05).LFA group significantly scored lower than HFA group on CVP, expressive language (EL), receptive language (RL), fine motor (FM) and visual motor imitation (VMI) subtests (P<0.05).For the communication composite and motor composite, children with LFA exhibited "low-high" trend (51.68±14.34 VSs 75.08±9.00, P<0.001), while HFA group presented "balanced" phenomenon (91.40±12.93 VS 87.02±11.66, P=0.205). Conclusion Children with ASD of different intelligence level exhibites differently on PEP-3.

Application value of the amplitude integrated electroencephalography in early diagnosis and treatment of hypoxic-ischemic encephalopathy and predict prognosis.

WEI Wei, SHANG Ming-xia, HAN Tao, HAN Xiao, CHAI Yan-nan, YIN Xiao-juan.

2014, 22(4):  361-364.  DOI: 10.11852/zgetbjzz2014-22-04-08

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Objective To evaluate the application value of the aEEG in early diagnosis and treatment of hypoxic-ischemic encephalopathy (HIE) and long-term prognosis. Methods A total of 120 cases of newborns with HIE who were hospitalized from August 2010 to February 2013 were selected, and their gestational ages were from 34~42^<sup>+2 weeks.120 cases of newborns were randomly dividing into the observation group with aEEG and non-observation group.According to the severity of HIE, each group was divided into mild, moderate, and severe subgroup, each subgroup with 20 cases.aEEG was respectively traced at time points(1, 3, 14 and 28 days) after birth for observation group with aEEG;Two groups of HIE took the Neonatal Behaviral Neurologieal Assessment (NBNA) assessment at time points(3, 14 and 28 days) after birth;follow-up research for two was done groups after corrected gestational age of 12 months, the follow-up investigation including Denver Developmental Screening Test (DDST) and nervous system sequelae. Results There was positive correlation between aEEG and HIE clinical indexing (r= 0.843, P<0.01).At time points(3 and 14 days)after birth, it was not statistically significant for the NBNA score between observation group with aEEG and non-observation group (P＞0.05)while it was statistically significant for the NBNA score between observation group with aEEG and non-observation group at time point 28 day after birth(P＜0.05).At time points (1, 3, 14 and 28 days)after birth, the aEEG results for observation group with aEEG had strong positive correlations with prognosis after corrected gestational age of 12 months(r=0.832, 0.857, 0.778, 0.743, P＜0.01).The disable rate in the observation group with aEEG (13.8%) was significantly lower than that in the non-observation group (23.2%); the cure rate (60%) in the observation group with aEEG was significantly higher than that in the non-observation group (40%).The long-term prognosis of the observation group with aEEG and the non-observation group was statistically significant (χ²= 4.107, P<0.05). Conclusions The aEEG has excellent correlation with HIE clinical indexing, and can assist in early diagnosis and treatment of HIE.aEEG can be used to predict long-term prognosis of HIE.

Relationship between lead low-level exposure and telomere length in neonates.

ZHAO Yan-fang, QU Bao-ming, MA Hai-yan, WANG Yun-ying, LI Hong.

2014, 22(4):  365-367.  DOI: 10.11852/zgetbjzz2014-22-04-09

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Objective To investigate the relationship between lead low-level exposure and telomere length in neonates. Methods A total of 97 neonates who had lower umbilical cord blood lead levels than 100 μg/L were included in this study, which were divided into two groups(group A and group B)according to the lead levels of umbilical cord blood at 50 μg/L.The lead levels of group A was <50 μg/L, and group B was ≥50 μg/L.Blood lead content was determined by atomic absorption spectrophotometry.The relative telomere length of leukocytes was evaluated by a real time fluorescence quantitative polymerase chain reaction (PCR). Results There were 68 cases in the group A and 29 cases in the group B.Group B had shorter telomere lengths than group A (0.536±0.476 VS 0.803±0.568), which was negatively correlated with blood lead levels (r=-0.303, P=0.003).There was significant difference of telomere length between two groups(t=2.222, P=0.029). Conclusions The telomere length in neonate was associated with a higher umbilical cord blood lead levels.Lead low-level exposure may contribute to shorten the neonatal telomere length.

Comparison of neonatal critical illness score with score and pediatric risk of mortality III score in predicting mortality risk in critically ill neonates.

WU Jian-rong, GU Qiang.

2014, 22(4):  368-370.  DOI: 10.11852/zgetbjzz2014-22-04-10

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Objective To compare the advantages of critically ill neonates mortality risk prediction between neonatal critical illness score (NCIS) and pediatric risk of mortality score and to research for the better neonatal disease severity scoring system feasible for use in our country.Methods The 135 neonates, who were in neonatal intensive care unit（NICU）from January 2012 to June 2013 in the first Hospital Affiliated to Shihezi University, were scored by NCIS and pediatric risk of mortalityⅢ (PRISM Ⅲ).According to the simultaneously scores the patients were divided into three groups（very critical group, critical group, non-critical group）, and mortality rates were compared in each group.At the same time the receiver operating characteristic curve（ROC） was drawn and counted out their areas under the ROC curves (AUC) to observe the specificity and sensitivity of two scoring systems in predicting the risk of death in critically ill neonates.Results The comparison between NCIS and PRISM III score:the differences were statistically significant in mortality among the noncritical, the critical and the very critical groups（P all ＜0.05）;the differences were not statistically significant in mortality among the non-critical, the critical and the very critical subgroups（P all ＞0.05）;AUC:NCIS 0.900, PRISM III 0.909.Conclusion Both NCIS and PRISM III can predict mortality risk in critically ill neonates, PRISM III is fully applicable in China.

Clinical significance of thyroid peroxidase antibody detection in umbilical cord blood.

HOU Li-ping, LIANG Li-yang, OU Hui, MENG Zhe.

2014, 22(4):  371-374.  DOI: 10.11852/zgetbjzz2014-22-04-11

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Objective To investigate the clinical significance of thyroid peroxidase antibody (TPOAb) detection in umbilical cord blood. Methods The thyroid function of umbilical cord blood was saved and tested, the relationship between TPOAb of umbilical cord blood and the thyroid function of mother and neonate, and its effects on neonatal short-term growth was analysed. Results 1)The positive neonatal cord blood TPOAb were related to maternal abnormal thyroid function, abnormal serum TSH and abnormal TPOAb of mother (χ²=48.55, 13.716, 251.1, respectively, P<0.001).2)The umbilical cord blood FT4 level of the neonates with positive umbilical cord blood TPOAb was lower than those with negative TPOAb neonates (P<0.05).3) Positive umbilical cord blood TPOAb had effects on neonatal birth weight(OR=3.239, 95%CI:1.072~9.781, P<0.05), birth length (OR=9.483, 95%CI:3.228~27.35, P<0.05) and head circumference(OR=3.669, 95%CI:2.34~5.75, P<0.05).4)The neonates with positive cord blood TPOAb had effects on their weight (OR=3.827, 95%CI:1.396~10.492, P<0.05) and personal-social ability(OR=2.8, 95%CI:1.178~6.654, P<0.05) when they were 5 months old. Conclusions Positive umbilical cord blood TPOAb is related to maternal abnormal thyroid function during pregnancy and can affect the physique and intelligence development of the neonates, therefore, strengthening the screening of thyroid function and thyroid autoantibody of gestational mother and closely follow-up those positive umbilical cord blood TPOAb neonates should be advocated.

Effect of n-3 polyunsaturated fatty on DNA methylation of the leptin promoter in obese mice.

WANG Cui, SHEN Wen-wen, FAN Chao-nan, XIA Lu-lu, DONG Hua, LU Yuan-yuan, QI Ke-min.

2014, 22(4):  375-378.  DOI: 10.11852/zgetbjzz2014-22-04-12

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Obejective To investigate the epigenetic mechanisms linking n-3 polyunsaturated fatty acids (n-3 PUFAs) and the increased leptin expression in obesity. Methods Thirty 3~4 week-old male C57BL/6J mice were randomly divided into 3 groups and fed 4 months with two different high-fat diets (34.9% of fat providing 40% of total energy), high-fat diets (lard oil and sunflower oil) and fish oil high-fat diet (lard oil and fish oil), and one lean control diet (lard oil and sunflower oil, 4.3% of fat providing 10% of total energy).After fasted for 12 hours, mice were sacrificed and epididymal fat was collected.The mRNA expression of leptin in fat was assessed by real-time PCR (RT-PCR).Bisulfite sequencing-PCR (BSP) was used to determine the methylation level of CpG sites in the leptin promoter.Chromatin immunoprecipitation (ChIP) and RT-PCR were used to determine the amount of DNA methyltransferase (DNMTs), methyl CpG binding protein 2 (MeCP-2) and RNA polymerase II (Poly II) associated with the leptin promoter. Results As compared to the lean control diet group, the leptin mRNA expression in fat from the high-fat diet group was increased, whereas no change was found in the fish oil high-fat diet group.The methylation level of CpG sites in the leptin promoter and the associated proteins, DNMT1, DNMT3a, DNMT3b, MeCP-2 were higher than the lean control diet group with reduced binding of Poly II.In the fish oil high-fat group, increased DNMT3a, DNMT3b and MeCP-2 binding to the leptin promoter were found and the extent of MeCP-2 increase was less compared to the high-fat diet group.No changes were found in the associated DNMT1 and Poly II, and methylation of the leptin promoter in the fish oil high-fat diet group. Conclusion Our findings suggest that the leptin expression may be associated with the promoter methylation of the gene and the binding proteins and RNA polymerase in obesity, and n-3 PUFAs regulate the leptin expression through these pathways.

Effects of naloxone on learning and memory ability in rats with repeated febrile seizures.

ZHANG Juan-li, YANG Li-fang, YAN Qin-qin.

2014, 22(4):  379-382.  DOI: 10.11852/zgetbjzz2014-22-04-13

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Objective To explore the effects and possible neural mechanisms of naloxone on learning and memory ability in rats with repeated febrile seizures (FS). Methods The warm water was adopted to induce rats FS model and to induce 21-days-old SD rats seizure one time every day, continuous up to 10 times.The rats were injected intraperitoneally with naloxone (1 mg/kg)immediately after FS occurred in naloxone-treated group(NT group, n=14), while the rats of FS-control group (FS group, n=14)were injected with equal volume 0.9% sodium chloride, the rats of normal-control group(NC group, n=12) were placed in 37℃ water about 5 minutes, then injected with equal volume sodium chloride.Latency, duration and grade of FS were observed and compared;step down test and step through test were used to detect short-term learning and memory ability;HE staining was adopted to observe the changes of histopathology in hippocampal neuron; Timm staining was used to observe mossy fiber sprouting (MFS) in hippocampus. Results 1)Seizure duration of NT group was shorter than that of FS group (P<0.05); seizure grade of NT group was significantly less than that of FS group (P<0.01);there was no significantly difference in seizure latency between two groups (P>0.05).2)Both step down test and step through test exhibited that the error times of FS group was at most, there were significant difference (P<0.01), but there were no significant difference (P>0.05) in NC group and NT group;after 24 hours, the step-down latency and step-though latency of FS group were obviously shorted, and had significant difference (P<0.05), there were also no significant difference (P>0.05) in NC group and NT group.3) HE staining showed that there were much lighter brain damage in NT group than in FS group.4) In FS-control group, Timm staining particle was significantly increased in the inner molecular layer of DG and stratum oriens of CA3 area, compared with NC group there had significant difference (P<0.01).Intervention with naloxone made it obviously decreased, compared with FS group significant difference could be seen(DG:P<0.01, CA3:P<0.05), but no significant difference compared with NC group (P>0.05). Conclusions Naloxone can lighten the brain damage resulted from repeated FS;Repeated FS can result in deficits of short-term learning and memory ability in rats, early intervention with naloxone can improve this recognition functional impairment;naloxone can degrade the degree of mossy fiber sprouting, this is one of possible neuromechanism of naloxone for improving cognitive dysfunction.

Effects of using dexamethasone in different time on injury lung in neonatal rats which of hyperoxia.

QI Ji, YANG Zhen-ying.

2014, 22(4):  383-386.  DOI: 10.11852/zgetbjzz2014-22-04-14

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Objectivs To study the effects of dexamethasone in different time on lung pathological morphology changes and growth development in neonatal rats which injury of hyperoxia, in order to providing the theoretical reference of dexamethasone to prevent and cure bronchopulmonary dysplasia (BPD). Methods The Wistar neonatal rats were designed in eight groups by random including:air group;hyperxia group;hyperxia group with early dexamethasone group and later dexamethasone group.Body weight, general situation and the death number of rats, the degree of pulmonary edema, alveolarization block and pulmonary fibrosis from lung coefficient calculation, alveolar interval thickness, radical alveoli count (RAC)and pulmonary fibrosis stocker score were recorded. Results The hyperxia group rats showed serious lung injury after exposed 95% oxygen.The general situation of early dexamethasone group rats was the worst and the degree of pulmonary edema, alveolarization block and pulmonary fibrosis were the most serious.The general situation of the later dexamethasone group was better and the growth increased faster than hyperxia group.But there had not significant differences in lung coefficient calculation, RAC, alveolar interval thickness and pulmonary fibrosis stocker score between the later dexamethasone group and the hyperxia group. Conclusions Early use dexamethasone has no action to prevent BPD, instead it may aggravated the hyperxia lung damage.Dexamethasone couldn't suggest as prophylaxis for BPD, dexamethasone should be used in the late therapy stages, and as small doses and short treatment as possible.

Efficacy of play therapy combined with shared reading on the mental coping capability of children with cancer.

JIA Xiao-qin, SUN Yu-qian, SUN Bing-fu, ZHAO Jia, CUI Ying, WANG Feng-ling, YU Hong-feng.

2014, 22(4):  397-399.  DOI: 10.11852/zgetbjzz2014-22-04-18

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Objective To explore the efficacy of group play therapy combined with shared reading on the mental coping capability of children with cancer. Methods Fifty-eight children with cancer were selected from four first-class hospitals in Tangshan, and were randomly assigned to intervention group(n=30)and control group(n=28).Children in intervention group received play therapy combined with shared reading for 3 months, while those in control group did not.The Coping With a Disease (CODI) was used to investigate the children's coping style before and after intervention between two groups. Results Compared with control group, the scores in wishful thinking, emotional reaction, distance and acceptance increased, and in avoidance and cognitive-palliative decreased in intervention group after intervention (P<0.05).The scores in control group did not differ before and after intervention (P>0.05). Conclusion Play therapy combined with shared reading can result in improvements in mental coping capability of children with cancer.

Study on the quality of life of school-age children with malignant tumors and the influential factors.

WANG Hua-rong, SUN Yu-qian, SUN Bing-fu, LI Hui-lan, CUI Ying, HAO Jing, ZHAO Li-hui, YU Hong-feng.

2014, 22(4):  400-402.  DOI: 10.11852/zgetbjzz2014-22-04-19

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Objective To investigate the quality of life of school-age children with malignant tumors and the influential factors analysis. Method A cluster random sampling method was conducted to recruit 240 children with leukemia and other malignancies in 8 first-class hospitals in Beijing and Tangshan from 2011 to 2012, and they were investigated by PedsQL^TM4.0 and PedsQL^TM3.0. Results 6~8 year-old children 's scores of physiological function (37.28±11.67), role function (51.72±11.43), operational anxiety (40.24±11.51), Communication (42.32±10.57) were below 9~11 year-old children (P all <0.05);while emotional function (59.43±14.53), social function (54.69±12.61), the anxiety of treatment (51.11±11.41), fear (64.19±12.49) and evaluation of appearance (70.14±11.67) were higher than 9~11 year-old children(P all<0.05).Multivariate stepwise regression analysis showed that child's age, disease duration>2 years, hospitalizations ≥ 3 times were into the regression equation (P<0.05). Conclusions 6~8 year-old children need more care in physiological function than 9~11 year-old children, while the 9~11 year-old children need more emotional support.The increasing times of hospitalizations of children with malignant tumor reduced children's quality of life.

Study on genetic correlation between infant asthma and bronchial asthma.

XU Jie, LIU Chang-yun, LI Jun-jie, FAN Meng-meng, DING Bao-dong.

2014, 22(4):  403-404.  DOI: 10.11852/zgetbjzz2014-22-04-20

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Objective To explore the mode of inheritance and genetic correlation was observed between the two of infant asthma and bronchial asthma, and provide a theoretical basis for the three grade prevention of asthma. Method Through the Falconer regression method to estimate the heritability of infant asthma and bronchial asthma, Logistic regression analysis of the major risk factors was summarized, S-N-K method were compared. Results The heritability for infants with asthma was (80.53±7.85)%, the heritability of bronchial asthma was (78.87±6.99)%.There was no significant difference between the two risk factors. Conclusion Genetic factors play a major role in the onset and development of asthma, other risk factors play a role, both have close correlation.Therefore, prevention of asthma in infants and young children can effectively reduce and prevent the occurrence of asthma.

Application of hydrogen proton magnetic resonance spectroscopy in infantile spasms.

DU Kai-xian, WANG Jun-fang, ZHAO Xin, JIA Tian-ming.

2014, 22(4):  405-407.  DOI: 10.11852/zgetbjzz2014-22-04-21

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Objective To study the brain biochemical metabolism changes of infantile spasms through hydrogen proton magnetic resonance spectroscopy(¹HMRS). Methods A total of 40 cases of infantile spasms and 10 age-matched normal infants were performed brain 1.5T MRI and multi-voxel ¹H-MRS exminations, volume of interest (VOI) included thalamus, basal ganglia, temporal lobe, the signal intensities of N-acetylaspartate(NAA), creatine+phosphocreatine (Cr), choline-containig compounds(Cho) were obtained, the ratios of NAA/Cho+Cr, Cho/Cr, and NAA/Cr were set into comparison bilaterally between the patients and controls. Results 1)The ratios of NAA/Cho+Cr, NAA/Cho, NAA/Cr were lower than normal group(P＜0.01), and the ratios of Cho/Cr were increased than normal group, the difference were statistically significant(P all ＜0.01).2)High lac peak could be seen in areas of lesions often. Conclusion The ¹H-MRS can noninvasively evaluate changes of cerebral metabolism in infantile spasms.

Epidemiology investigation on the helicobacter pylori infection of pre-school children in Shenyang.

ZHANG Xue-jiao, HUANG Yan-hong, YANG Liu, LI Li-li, LI Jing, NI Jia, XU Ling-fen.

2014, 22(4):  408-410.  DOI: 10.11852/zgetbjzz2014-22-04-22

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Objective To investigate the helicobacter pylori (Hp) infection situation of pre-school children in Shenyang and to discuss the relative factors of Hp infection. Methods A total of 1 150 children in eight kindergartens were randomly selected with the method of cluster sampling.Serum IgG antibodies of Hp were measured.A structured questionnaire was sent to the parents of these children to obtain the related information. Results The Hp infection rate of pre-school children was 13.13% in Shenyang and it was trending up with increasing by ages.The Hp infection rate was higher significantly in children with digestive symptom than that in children without digestive symptom.Individual dinnerware and high income were the protective factors for the Hp infection of pre-school children, and age, low income, nibbling figures or toys, not often washing hands and family numbers with a history of stomach disease were the risk factors. Conclusions Pre-school children in Shenyang are susceptible to Hp infection, though their Hp infection rate is lower than that of the average rate in China.It is important for children to decrease the Hp infection by training them to have good health habits.

Study on health-related quality of life of children with recurrent respiratory tract infection simultaneously inoculated by pneumococcal vaccine combined with influenza vaccine.

LI Xiao-lan, LI Xiao-jun, LU Jin-ling, XIE Fan.

2014, 22(4):  411-413.  DOI: 10.11852/zgetbjzz2014-22-04-23

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Objective To observe the health-related quality of life(HRQOL) of children with recurrent respiratory tract infection (RRTI)simultaneously inoculated by pneumococcal vaccine combined with influenza vaccine. Methods A total of 278 cases RRTI were randomly divided into two groups.The control group (n=135 patients) was used with placebo only while the vaccine group (n=143 patients) was simultaneously inoculated with pneumococcal vaccination combined with influenza vaccine.The PedsQL^TM 4.0 scores and clinical indicators were observed in each group before the inoculations; 14 months and 26 months after the inoculation. Results There were no significant differences in the number of cases, gender, age, duration and SES score in the two groups (P>0.05);The incidence of upper and lower respiratory tract infection, respiratory diseases caused by the frequency of fever, the number of days of antibiotic use and total cost of treatment in the vaccine group were significantly less than those of the control group (P<0.05);The PedsQL^TM 4.0 score showed no significant difference in both groups(P>0.05) before the inoculation;Each dimension of the quality of life of the vaccine group significantly increased as inoculation time extended (P<0.05), while those of control group showed no significant difference (P>0.05). Conclusion Combination of inoculation of pneumococcal vaccine and influenza vaccine can effectively improve the HRQOL of RRTI children as well as the PedsQL^TM 4.0 score and it should be highly recommended clinically.

Correlation between Th17 cell, Interleukine-17 and airway inflammation after respiratory syncytial virus bronchiolitis.

ZHAO Qian-ye, ZHOU Xu-hua, YU Yan-yan, DING Tie-mei, SUN Qian, SHI Su-jie, WANG Yi-fen, XIAO Guang-yan, XU Hai-yan, XIA Li-juan, SUN Da-quan, QIAN Qian, YAN Xiao-fang.

2014, 22(4):  414-415.  DOI: 10.11852/zgetbjzz2014-22-04-24

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Objective To investigate the correlation between Th17 cell(Th17) , Interleukine-17(IL-17) and airway inflammation through examining the concentration changes of Th17 and IL-17 in serum of children who were suffering from respiratory syncytial virus (RSV) bronchiolitis. Methods Forty infants with the primary RSV bronchiolitis were recruited in this study.Two milliliter blood samples were collected in the acute phase and the recovery phase, respectively.The ratio of Th17 cell was analyzed by flow cytometry, and the concentration of IL-17 was analyzed by and ELISA. Results The ratio of Th17 cell and the concentration of IL-17 in the acute phase of RSV bronchiolitis were both significantly higher than those in the recovery phase(P＜0.01).Moreover, compared to children with mild RSV bronchiolitis, these two indexes in children with severe RSV bronchiolitis were both increased significantly in the acute phase (P＜0.01), but no significant changes were detected in the recovery phase(P＞0.05). Conclusions Th17 cells and IL-17 might be involved in the airway inflammation in the acute phase of RSV bronchiolitis, and be associated with the severity of the disease.

Retrospective study of preterm infants with respiratory distress syndrome during 1998-2012.

HAN Tong-yan, TONG Xiao-mei, PIAO Mei-hua, LI Zai-ling, CUI Yun-pu, TANG Ya-nan, CHANG Yan-mei.

2014, 22(4):  416-419.  DOI: 10.11852/zgetbjzz2014-22-04-25

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Objective To study changes of treatment in preterm infants with respiratory distress syndrome (RDS) during 1998-2012. Methods Retrospective observational study of infants, <34 weeks gestation, born between January 1998 and December 2012.A group was the cases during the first 7 years(n=63), and B group was the cases during the next 8 years(n=151).Perinatal data, birth history treatment (including respiratory support, surfactant therapy and doses), complications and outcomes were compared. Results The birth weight of B group was (1 284.50±252.153)g, significantly lower than A group [(1 424.27±329.44)g](t=3.292, P<0.001).The amount of surfactant in group was (169.66±57.97) mg, significantly lower than that of B group [(195.00±59.87) mg](P=0.041).The requirement of intubation ventilation support in A group was 39 cases (90.7%), higher than 85 cases in B group (70.8%)(χ²=6.86, P<0.01).In group B, 33 cases (27.5%) developed BPD, which was more than 4 cases (9.3%) in A group (χ²=5.97, P=0.02).The length of hospitalization, NICU stay and oxygen dependence in B group were longer than A group.The mortality of B group was lower than A group, 11.7% versus 27.9% (χ²=6.23, P=0.01). Conclusion In the last decades, exogenous surfactant replacement has been established as an effective and safe therapy in RDS preterm infants.

Test and analysis of the heel filter paper blood thyrotropin level of preterm infants.

LIU Wei, KONG Yuan-yuan, WANG Lin-lin, HU Jin-chun, JIAN Yong-jian, LU Li-hong, LI Yan-xia, MA Zhi-jun.

2014, 22(4):  420-422.  DOI: 10.11852/zgetbjzz2014-22-04-26

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Objective To understand the heel filter paper blood thyrotropin (TSH) level of preterm infants, and explore the appropriate screening time on preterm infants so that provide more exact diagnostic criteria to clinic. Methods A total of 4 606 specimens of preterm were seek out from more than one hundred specimens of neonatus borned in Beijing in 2011, and were divided into six groups according to different gestational age, screening time, birth weight, and established term infants group as control.TSH value was detected by DELFIA method, and distribution and the differences of TSH in preterm infants were analyzed between those groups by statistical software. Results The heel filter paper blood TSH level of preterm infants was lower than that of full-term infants as a whole, and very-low-birth-weight infants and extreme preterm infants in the exists obviously of individual differences, distribution was not balanced;The TSH level of preterm infants in delay screen over two weeks was declined, general preterm infants for overall balanced declined, extreme preterm infants and very-low-birth-weight infants in centered of level changed slightly, but department of percentileis was rise in terminal high value;The TSH cut-off of general preterm infants and full term infants were basically the same, but dropped significantly in extreme preterm infants and very-low-birth-weight infants, and also in delay screen over two weeks. Conclusion Establish TSH cut-off should consider different gestational age, birth weight and blood collection time of effect.

Study on epidemiological characteristics and influencing factors of unintentional injuries among rural children in Dongming county, Heze city.

JIA Gai-zhen, SONG Long-di, XU Tian-he, WANG Li-ping.

2014, 22(4):  423-425.  DOI: 10.11852/zgetbjzz2014-22-04-27

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Objective To assess the epidemiologic characteristic of childhood nonfatal unintentional injuries aged 3~14 in rural area and explore related factors and provide guide for injury prevention and intervention. Methods A total of 475 children of 4 middle schools and 2 kindergartens in Dongming township were enrolled into this study by using a stratified cluster sampling method in Heze city.Parents of the children were surveyed with a questionnaire.SPSS 13.0 software was used to analyze the data. Results The incidence rate of unintentional injuries was 11.45%.The first three types of accidental injuries were collisions (20.53%), falls (18.95%) and poisoning (13.68%)accident for rural children aged 3~14.The places where injuries occurred were mainly at home(25.3%) and leisure activities(23.7%).The main body parts of injuries were arms and face (77.8%), disability account for 3.1% in the severity of the accident.Gender, parents' cultural degree, children personality and left-behind children were the risk factors for rural children accidental injury.The cognitive degree of parents in accident group were significantly lower than non-damaging group(P<0.05). Conclusions Rural children's accidental injury incidence is higher in Heze city.Fall and collision is the main damage types.The parents' knowledge about injury and cultural degree is the most obvious factors for rural children unintentional injury.

Influence of early intervention on motor development prognosis of infants at high risk of cerebral palsy.

XIE Li-lin, WANG Rong, WU Xiu-fang, ZHAO Xiao-hua, WANG Li-li.

2014, 22(4):  426-428.  DOI: 10.11852/zgetbjzz2014-22-04-28

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Objective To observe the effect of early intervention on the motor development prognosis of infants at high risk of cerebral palsy, and to investigate whether early intervention could decrease the incidence of cerebral palsy and improve the degree of motor development. Methods A follow-up visits on 307 infants at high risk with cerebral palsy were finished, and 140 infants with brain injury were carried out about early intervention.The gross motor and fine motor of Gesell Scale of Infant Development were used to evaluation. Results Remarkable difference was found before and after follow-up in 140 infants with brain injury(all P＜0.01).After follow-up, normal group was much better than cerebral palsy group and control group(all P＜0.01) in gross motor and fine motor.There was difference between cerebral palsy group and control group in fine motor(P＜0.05), and no difference in gross motor(P＞0.05). Conclusion Early intervention plays an important role in improving the motor development of infants at high risk of cerebral palsy, and induces the degree of cerebral palsy, especially in fine motor.

Monitoring analysis of collective children unintentional injury in kindergarten in Xicheng district of Beijing from 2005 to 2011.

HE Shu-qing, ZHANG Xiao-wen, WANG Xiao-ping.

2014, 22(4):  429-431.  DOI: 10.11852/zgetbjzz2014-22-04-29

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Objective To understand the condition of collective children unintentional injury in kindergarten in Xicheng district from 2008-2012, and provide the scientific instruction for the prevention of child unintentional injury in local kindergartens. Method The monitoring data of collective children injury and accident in kindergarten in Xicheng district were retrospective analyzed, to describe the occurrence of child injury and accident in kindergarten. Results During 2008-2012, the incidence rate of collective children unintentional injury in kindergarten in Xicheng district was 0.43%.Falls were the main injury type, with the incidence rate 0.22%~0.48%, and showed declining trend year by year(χ²=13.32, P=0.01).The major accident type was fracture, with incidence rate 0.04%~0.10% in past four years. Conclusion Xicheng district has low incidence rate of collective children unintentional injury in kindergarten.The important mission of injury intervention is preventing child falls and fracture.

Analysis of helicobacter pylori infection and its risk factors in school-age children.

LIU Yan-qi, ZHAO Ai-zhen, SU Bing-zhong, SUN Yan-hong.

2014, 22(4):  432-434.  DOI: 10.11852/zgetbjzz2014-22-04-30

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Objective To study on gastrointestinal symptoms of helicobacter pylori (Hp) infection rate and related risk factors in school-age children. Methods A total of 498 cases with gastrointestinal symptoms were detected with school-aged children ¹⁴C-urea breath test for Helicobacter pylori infection;and life questionnaire of school-age children was used. Results School-age children in the region of Hp infection rate was of 30.32%; multivariate unconditional Logistic regression analysis revealed that the per capita living space was small, parents with stomach problems, low family income, and the history of shared brush cup were school-age children, pets, love eating finger were important risk factors of Hp infection. Conclusion Rate of Helicobacter pylori infection in children is high.To strengthen the publicity and education work of school-aged children health knowledge, develop good health eating habits have importance to prevention of Helicobacter pylori infection.

Correlation of neurologic subtype and complications to gestational age and birth weight of preterm infants with cerebral palsy.

YAN Shu-yuan, LIU Zhen-yu, KUANG Xiao-ni, QIAN Hong-yan, OU De-fei.

2014, 22(4):  435-437.  DOI: 10.11852/zgetbjzz2014-22-04-31

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Objective To analyze the correlation of neurologic subtype and complications to gestational age and birth weight of preterm infants with cerebral palsy (CP). Methods A total of 135 cases of preterm infants with CP were received the following examinations:CP classification, intelligence capacity test, speech assessment, ophthalmologic consultation, brainstem auditory evoked potential and electroencephalogram.SPSS 11.5 software was used to analyze statistically. Results 1)There were 284 complications in total, and the average complication was (2.10±1.33) per child.2)The constitute ratio of CP, the incidence of spastic quadriplegia, mental retardation, speech disorder, visual impairment, musculoskeletal disorder , epilepsy and the number of complications of the group of <32-week were significantly higher than those of the group of 32~33-week, and/or that of the group of 34~36-week.3)The constitute ratio of CP, the incidence of spastic quadriplegia, mental retardation, speech disorder, visual impairment, musculoskeletal disorder epilepsy and the number of complications of the group of <1 500 g were significantly higher than those of the group of 1 500~2 499 g, and/or those of the group of ≥2 500 g. Conclusion The incidences of spastic quadriplegia, mental retardation, speech disorder, visual impairment, secondary musculoskeletal disorder epilepsy and multiple disorders are higher in the small gestational age preterm and very low birth weight infants.

Analysis of newborn disease screening results from 2006 to 2012.

MENG Xiang-ping.

2014, 22(4):  438-440.  DOI: 10.11852/zgetbjzz2014-22-04-32

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Objective To analyze congenital hypothyroidism (CH) and phenylketonuria (PKU) in Xi'an from 2006 to 2012 about its screening situation, the incidence and the recall rate. Methods Using retrospective analysis method, the apply time-resolved immunofluorescence and immunofluorescence method were used to determine the concentration of Tsh and Phe. Results A total of 384 336 newborns were screened from 2006 to 2012 in Xi'an Neonatal Screening Center.263 cases were confirmed positive for CH, with an incidence of 1∶1 461, 153 cases were confirmed positive for PKU, with an incidence of 1∶2 512.The number of screening by 20 008 rose to 86 375 from 2006 to 2012, CH positive detection rate by higher for 1∶6 669 to 1∶1 464, PKU positive detection rate by 1∶5 002 to 1∶2 399, screening rate rose to 85.16% from 40.41%, the recall rate increased from 70.7% to 96.0%.The positive, screening rate and recall rate were on the rise year by year. Conclusions Early discovery, diagnosis and treatment are of great help in disease prevention among newborns and avoiding low intelligence, physical development, organ damage, avoid to bring burden to the society and family.Improving the birth population quality is an effective measure to reduce the incidence of birth defects.

Neonatal mortality trends analysis in Gansu from 2004 to 2011.

LIU Hong, HUANG Lei, LIU Shu-wen, ZHANG Ling, YI Bin.

2014, 22(4):  441-444.  DOI: 10.11852/zgetbjzz2014-22-04-33

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Objective To explore the condition and trends of neonatal mortality of Gansu from 2004 to 2011 and to propose protective measures to reduce neonatal mortality. Method Mortality monitoring data of children under 5 years old form 2004 to 2011 were analyzed to obtain neonatal mortality trends. Results The neonatal mortality of 2004-2011 was 9.73‰.The rates in rural area(15.62‰) was significantly higher than that in urban area(6.77‰) ( χ²=20.172, P<0.05).Compared to 2004, the neonatal mortality of urban, rural area and the total province decreased by 9.40%, 11.77% and 10.36%, respectively.The mortality of neonatal and post-neonatal was 8.08‰ and 1.65‰, respectively.The neonatal mortality in rural area(12.76‰) was significantly higher than that in urban area(5.72‰).The main causes of neonatal death were newborn asphyxia, premature birth, low birth weight, birth defects, pneumonia and infection. Conclusions The neonatal mortality was significantly decreased, but still higher than the national average.The rates showed difference between urban and rural area.The quality of obstetric work and perinatal care should be improved to reduce the neonatal mortality.

Clinical application of fractional exhaled nitric oxide monitor in children with asthma.

LIU Yan-lin, TANG Su-ping, CHEN Shen, DONG Li, HUA Yun-han, GUO Yi-hua.

2014, 22(4):  445-446.  DOI: 10.11852/zgetbjzz2014-22-04-34

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Objective To assess the value of fractional exhaled nitric oxide (FeNO) monitor in the control of children with asthma. Methods A total of 50 children with light, moderate and severe asthma from department of allergy were selected into the experimental group.FeNO concentrations, pulmonary function test, the score of the day night time asthma symptom were detected and analyzed before and after treatment of 3 months and 6 months .At the same period, 50 cases of healthy control group were detected FeNO. Results 1)Compared with no treatment, FeNO value decreased significantly after 3 months treatment, the difference was statistically significant (P<0.000 1), but there was no statistically significant difference between the 3 months and 6 months treatment (P>0.05) in the experimental group.2)FeNO concentrations and the score of symptom in the day night time asthma were all decreased significantly for 3 months and 6 months treatment in the experimental group.The FEV1% , the FVC, the PEF value of lung function were all increased significantly for 3 months and 6 months treatment in the experimental group(P＜0.05).3)The FeNO value before and after treatment in the experimental group were significantly higher than that in the control group (P<0.000 1). Conclusion FeNO concentrations can evaluate airway inflammation in children with asthma as a good indicator.