Table of Content

10 July 2014, Volume 22 Issue 7

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Study on status and the influencing factors of child health clinics in county-level maternal and child health institutions in China.

HE Zhi-min, WANG Hui-shan, XU Tao, PAN Xiao-ping, ZHOU Miao, ZHANG Tong

2014, 22(7):  677-679.  DOI: 10.11852/zgetbjzz2014-22-07-03

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Objective To understand the situation of child health services and clinics in county-level maternal and child health (MCH) institutions and provide scientific basis to standardize such clinical services. Methods Multi-stage stratified sampling method was used to investigate the situation of child health clinics of county-level MCH institutions in 2012.The differences and influencing factors of such clinical services among different regions and levels were analyzed. Results The results showed that the rates of setting child health clinics were about 50% in 232 county-level MCH institutions.Not statistically significant difference was observed of the rates of setting outpatients in MCH institutions between county level and district level (P>0.05).The differences of the rate of setting hearing care clinic among eastern, central and western regions were statistically significant (P<0.05).The number of child health clinics was related with the number of staff members and housing area of institutions and child health clinics. Conclusions The situation of child health clinical services at county-level MCH institutions in China is not optimistic for a low setting rate of child health clinic and existing regional differences at various degrees.Thus, it is important to increase the investment on the number of staff and child care clinic facilities.

Predictive value of qualitative assessment of general movements for motor developmental outcome (cerebral palsy) in full-term infants with cerebral damage.

SU Yun-peng, YANG Hong, SHI Wei, CHEN Ming, LI Hui, ZHU Mo, LIAO Yuan-gui, SHAO Xiao-mei

2014, 22(7):  680-682.  DOI: 10.11852/zgetbjzz2014-22-07-04

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Objective To study the predictive value of qualitative assessment of general movements (GMs) for motor developmental outcome (cerebral palsy) in full-term infants with cerebral damage. Methods A total of 55 full-term infants with brain damage were retrospectively included in the Rehabilitation Department of Children's Hospital of Fudan University.All of them received GM assessments at least once during fidgety-movement period and their motor development outcome were determined after 1-year-old by their neurological examination and results of Peabody Developmental Motor Scale-2.Sensitivity, specificity, positive predictive value and negative predictive value of GMs assessment for cerebral palsy were calculated. Results Among the 55 infants with brain damage, 20 infants didn't show fidgety movements while 35 did.After 1-year-old, 19 children were diagnosed with cerebral palsy while 36 children were not.The predictive values of GMs assessment for cerebral palsy were as following: sensitivity 89%, specificity 92%, positive predictive value 85%, negative predictive value 94%. Conclusions The qualitative assessment of GMs has a good predictive value for long-term motor developmental outcome (cerebral palsy) in full-term infants with brain damage.As a new method of non-invasive, non-intrusive neurological assessment, the assessment of general movements is suitable for wide application in follow-ups among full-term infants with brain damage.

Epidemiological characteristics of measles in Hubei province, 2006-2012.

YAO Xing-peng, ZHANG Chi, WANG Xiao-nan, WANG Lei, LI Qiong, TANG Xian-feng, LI Jin-ze

2014, 22(7):  683-686.  DOI: 10.11852/zgetbjzz2014-22-07-05

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Objective To investigate the epidemiological characteristics of measles in Hubei Province, and to provide a scientific basis for measles elimination strategies. Methods By descriptive epidemiology research methods, measles cases reported in Hubei Province 2006-2012 were analyzed to explore factors influencing the epidemiological characteristics of measles in Hubei Province. Results CCP monitoring reporting system reported 604 cases of suspected measles in 7 years, 15 388 cases were diagnosed measles cases, 2 520 cases of laboratory diagnosis, 12 868 cases of clinical diagnosis, 12 156 cases were reported under 15 years old;Annual incidence rates were 4.02/10⁵, 6.42/10⁵, 6.88/10⁵ and 7.01/10⁵ in 2006-2009, showing the state of the overall height of sporadic;Different months had occurred throughout the year, which was high in April and May, the peak of incidence in May;Sex ratio 1.74∶1;Larger proportion of small age group, the minimum age was 24 d;In the vaccination history from 2009 to 2012, case without history of immune were 30.29%, 29.41%, 33.72%, 66.83% respectively in monitoring data;8 634 cases were scattered children, accounting for 56.10%;2 482 cases were students, accounting for 16.13%. Conclusions Improving vaccination rates for measles vaccine, the success rate of immunization and leak replant are the key measures in reducing or eliminating the incidence of measles, strengthen routine immunization in young age and immune response strategies for measles immunization program in Hubei province is especially important.

Correlation between internet use and emotion of junior middle school students.

CHANG Xian-lu, WANG Hua-yun, ZHANG Yan

2014, 22(7):  687-689.  DOI: 10.11852/zgetbjzz2014-22-07-06

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Objective To explore the correlation between internet use and emotional state of junior middle school students, and to know influencing fators on internet overuse. Method A total of 825 urban and rural junior middle school students were investigated with general condition questionnaire, The Screen for Child Anxiety Related Emotional Disorders ted with (SCARED), Depression Self-Rating Scale for Children (DSRSC) and Internet Self-Rating Scale. Results It checked out 44 students overusing internet, and the detection rate was 5.33%.The difference between boys and girls was significant (χ²=10.39, P=0.002)[32 boys(3.88%), 12 girls(1.45%)].There was obvious emotion difference between internet overusing and no-overusing.The anxiety and depression in internet overusing group was serious than that of no-overusing group (P<0.01).Correlation analysis discovered that totle scores of internet use were closely related with anxiety, depression, grade, age, gender, parents culture etc.Multiple regression analysis showed that school terror, depression, father culture, gender and so on were dangerous influencing factors on overusing internet. Conclusion Much attention should be paid to internet overusing issue of junior middle high school students.Internet overusing and emotional disorder are significantly related, with emotional disorder, low culture of father, boy students are risk factors on overusing internet.

Research on serum vitamin A, iron, and zinc status of 336 infants aged 0~18 months in rural area of Shaanxi province and the relationship with Hb.

YANG Yuan-yuan, LIU Li-ming, YANG Wen-fang, ZHANG Shui-ping, WANG Yi

2014, 22(7):  690-692.  DOI: 10.11852/zgetbjzz2014-22-07-07

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Objective To understand the serum vitamin A, iron, and zinc status of infants aged 0~18 months in rural arear of Shaanxi province, and the relation with Hb. Method Hb and serum vitamin A, iron, zinc were detected in 336 infants, and the content of which were compared between the anemic children and the normal children. Results The deficiency rate of serum vitamin A, iron, and zinc were 67.27%, 29.1% and 90.9%, respectively.The average content of serum vitamin A, iron, and zinc in anemic group (0.54 μmol/L, 881.21 μg/L, 610.01 μg/L) were lower than those of control group(0.81 μmol/L, 1 227.93 μg/L, 679.40 μg/L), and there were statistical significance (P<0.05). Conclusion The deficiency of serum vitamin A, iron, and zinc are serious in rural area of Shaanxi province.The contents of serum iron and zinc are positively associated with hemoglobin concentration.

Study on two-week prevalence of rural preschool left-behind children in Shandong province.

HUI Ya-ru, ZHANG Jing-jing, GAI Ruo-yan, XU Ling-zhong, CUI Yi-meng, QI Hua-jin

2014, 22(7):  693-695.  DOI: 10.11852/zgetbjzz2014-22-07-08

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Objective To study preschool left-behind children's health status and relative behaviors, and provide scientific reference for improving their health. Methods The method of stratified-cluster-random sampling was used in this study.A total of 735 left-behind children aged 0~7 years old were sampled from 2 counties and 6 nursery schools of Shandong, and surveyed with self-made questionnaire. Results There was significant difference in different types of nursing of left-behind children who account for 36.6% in all respondents.Left-behind children or non left-behind both had higher medical behaviors. Conclusion Two-week prevalence of taking-care-by-father children is the highest, and strengthening the attention is advised on left-behind children to improve their health status and medical behaviors.

Study on relationship between social support and prosocial tendencies among the left-home kids in primary school.

YE Ying

2014, 22(7):  696-698.  DOI: 10.11852/zgetbjzz2014-22-07-09

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Objective To explore the relationship between social support and prosocial tendencies among the left-home kids in primary school, and provide theoretical reference to healthy growth education and positive qualities development of the left-home kids. Methods A total of 156 left-home kids and 163 non left-home kids were surveyed with Social Support Scale and Prosocial Tendencies Measure;Descriptive statistics, the T test, correlation and regression analysis were adopted to process the data. Results Social support and prosocial tendencies status of left-home kids was in medium high level;There were no significant differences on scores of subjective support, support utilization and 6 types of prosoical tendency between the left-home kids and non left-home kids;Left-home kids' objective support scores were significantly lower than that of non left-home kids (P<0.05).As for left-home kids, there was a certain degree of positive correlation between social support and prosocial tendencies(r=0.04~0.25, P<0.05 or <0.01).Subjective support was the significantly positive predictor for the public, anonymous, altruistic, compliant, dire prosocial tendencies.Support utilization was the significantly positive predictor for emotional prosocial tendency. Conclusions The more social support leads to the more prosocial tendencies among the left-home kids in primary school.Subjective support and support utilization are the main factors of prosocial tendencies.

Case-control study on the relationship between attention deficit hyperactivity disorder and asthma and allergic disease in children.

QIAN Xing-guo, ZENG Xiao-zhou, WANG Pei-xi, WEI Zhao-zhang, WANG Shi-qin, HUANG Min-hua, XIE Xia-ping

2014, 22(7):  699-701.  DOI: 10.11852/zgetbjzz2014-22-07-10

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Objective To explore the association between attention deficit hyperactivity disorder (ADHD) and asthma and allergic disease in children. Methods A 1∶1 matched case-control study of 278 children with ADHD and 278 normal children were investigated in asthma and allergic disease.The Chi-square test was used to test single factors while multi-factors inspection was test by conditional Logistic regression analysis. Results The suffering from asthma and eczema in cases and control group had no significant difference (2.9% vs 1.1%, 4.3% vs 1.8%, respectively, P>0.05).The incidence of allergic phenomenon such as itchy rash for six months, once diagnosed rhinitis, recent one year to have asthma symptom, and often have a runny nose, itchy eyes, nasal congestion were significantly higher than those of control group (P<0.05).Allergic rhinitis (P=0.029, OR=2.021, 95%CI:1.074~3.803), and often have a runny nose, eye itching, nasal congestion (P=0.012, OR=1.863, 95%CI:1.147~3.024) were risk factors for ADHD by conditional Logistic regression analysis. Conclusions Allergic rhinitis with a runny nose, itchy eyes, nasal congestion are associated with ADHD.Further studies need to be done in exploring the relationship of asthma or eczema with ADHD.

Role of L-thyroxine on brain tissue hypoxia-inducible factor 1α expression after hypoxia-ischemia brain damage in neonatal rats.

ZHANG Xiao-li, JIA Tian-ming, DU Kai-xian, ZHAO Shan-shan, NIU Guo-hui

2014, 22(7):  702-704.  DOI: 10.11852/zgetbjzz2014-22-07-11

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Objective To observe the expression of hypoxia-inducible factor 1α(HIF-1α) in rat brain after hypoxia-ischemia brain damage (HIBD) and L-thyroxine (L-T4) of different dose treated. Methods Eighty postnatal 7 days old Sprague-Dawley(SD) rats were randomly divided into 5 groups :the sham operation group, hypoxia-ischemia group (HI), menstruum-treated group, L-T4-treated groups of low and high dose.The rats of menstruum-treated, L-T4-treated groups of low and high dose were respectively daily administrated of intraperitoneal injection of menstruum of the equal volume and 2 μg/100 g L-T4, 3.5 μg/100 g, once a day, for 5 days.The expression of HIF-1α were detected by immunohistochemistry.Reverse transcription-polymerase chain reaction(RT-PCR) was used to detect the level of HIF-1α mRNA. Results Compared with the sham operation group, the levels of HIF-1α protein(38.581±2.846) and HIF-1α mRNA(0.174±0.015) were upregulated in HI group(72.795±6.121, 0.448±0.035 respectively), as well as in menstruum-treated group.The levels of HIF-1α protein (117.350±9.374, 142.842±8.948 respectively)and HIF-1α mRNA(0.618±0.042, 0.711±0.049 respectively) in L-T4-treated groups of low and high dose were higher than HI group(P<0.05).The influence of L-T4 on HIF-1α protein and HIF-1α mRNA was dose dependent, namely with the increase of dose, their expression increased (P<0.05). Conclusion L-T4 upregulats HIF-1α mRNA and protein expression in neonatal rats with HIBD.

Effect of various ischemic methods on the ocular ischemic syndrome in the neonatal rat model of periventricular leukomalacia.

YANG Li, CAO Yun-tao, JING Xiu-jie, ZHUGE Xiao-yin, LIU Hua-qing

2014, 22(7):  705-708.  DOI: 10.11852/zgetbjzz2014-22-07-12

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Objective To investigate the effect of various ischemic methods on the pathological change of brain and ocular ischemic syndrome in the Sprague-Dawley (SD) neonatal rats with periventricular leukomalacia(PLV). Methods Two-old-day SD neonatal rats were randomly divided into three groups:the unilatera group, the bilateral group, the sham operation group.Unilateral group by ligation of right common carotid artery, bilateral group were treated with the bilateral common carotid artery-ligation, both of them followed by 8%O₂+92%N₂ for 1 hour.The pathological changes in the brain were examined by optical microscope, and the ocular ischemic syndrome were monitored dynamic in the three groups. Results 1)Eye lesions:on day 1 after operation, the eyes were displaying purple swelling in the bilateral group; at the 11^th and 18^th days after operation, there were various degrees of eye lesions in bilateral group, such as the palpebral fissure narrowed, atrophy of eyeball, single or both blind, lens opacity and cataracts were confirmed by slit lamp, there were no eye lesions in the unilatera group and the sham operation group.2)Pathological changes of brain:On the 4^th day after operation, neurocytes loose, edema, necrosis, microglia proliferation could be observed, and the bilateral group was more serious than the unilateral group, and even the liquefactive necrosis could be observed in the bilateral group;On the 11^th and the 18^th day after operation, the periventricular white matter reduction and the local malacia around the periventricular area were observed in the bilateral group and the unilateral group, the damage of brain in the bilateral group was serious than the unilatera group, there were no changes in the sham operation group. Conclusions This study suggests that the PVL animal model of two-day-old neonatal rat is successfully established by the ligation of unilateral common carotid artery or bilateral common carotid artery, and then exposure hypoxia for 1 hour; and also accompany with ocular ischemic syndrome by the ligation of bilateral common carotid artery in 2-day-old neonatal rat.

Correlation of distribution of c-fos and neuropetdides in lung of asthmatic rat.

LIU Hai-yan, HOU Wei, YANG Xu-dong, ZONG Chang-hong

2014, 22(7):  709-712.  DOI: 10.11852/zgetbjzz2014-22-07-13

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Objective To investigate the change of distribution of c-fos and neuropetides in the lung of asthmatic rat. Methods Thirty-two Wistar rats were divided into control group, asthmatic recover group, acute episode group, dexameth intervention group.Immunohistochemistry and computer image analysis were used to observe the c-fos change of the lung and the contents of substance P(SP) and vasoactive intestinal peptide(VIP) in lung tissues were detected by ELISA. Results The contents of SP in the BALF of asthmatic recover group, acute episode group, dexameth intervention group rats were significantly higher than that in control group(P＜0.000 1), and the contents of VIP were significantly lower.There were significantly positive correlations between the SP and the optical density value of c-fos(r=0.908, 0.967, 0.865, P<0.05 or <0.001).There were significantly negative correlations between VIP and optical density value of c-fos (r=-0.974, -0.949, -0.962, P all ≤0.001). Conclusion There is correlation between neuropeptides, c-fos proteinum and asthmatic attack asthmatic rats.

Study on relationship between high risk newborn writhing movements period and infant spasms.

WANG Yu-qing, YANG Zhong-xiu, ZHU Ping, LI Zhi-lin

2014, 22(7):  727-729.  DOI: 10.11852/zgetbjzz2014-22-07-19

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Objective To investigate the correlation between high risk newborn writhing movements period and infant spasms. Methods A total of 178 high risk infants follow-up in rehabilitation department were accepted the qualitative assessment of general movements respectively in the writhing movements period.Statistical analysis of babies with infant spasms was made after 12-month-age(corrected age of premature infants). Results Cramped-synchronised movements had predictive value for infantile spasms.There was a significant difference in the incidence of infantile spasms between the cramped-synchronised movements and the poor repertoire movements (P<0.01).The predictive validity of infant spasms were as follows:sensitivity 90.9%, specificity 96.8%, positive predictive value 80%, and negative predictive value 98.7%. Conclusion Only the cramped-synchronised movements of writhing movements period have predictive value.Infants with cramped-synchronised movements should be regularly carried out 24 hours of dynamic electroencephalogram.

Molecular epidemiological research of deafness predisposing genes in newborns of Foshan.

ZHANG Zhang, FAN Lian, LIU Ying, LI Zhen-an, YU Feng-ci, DAI YI-heng

2014, 22(7):  730-732.  DOI: 10.11852/zgetbjzz2014-22-07-20

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Objective To explore the features of molecular epidemiology of deafness predisposing genes and to provide a basis for optimizing the strategy for pre-deaf through universal newborn genetic screening. Methods A total of 1 902 newborns were taken blood spot at heel in 3~5 days and accepted deafness predisposing genes screening.All samples performed the polymerase chain reaction (PCR)for screening GJB2 and the mitochondrial 12SrRNA as well as SLC26A4 gene mutations.Eight mutations of three genes(GJB2 35delG, 176-191del 16, 235delC and 299-300delAT, SLC26A4 IVS7-2A>G and 2168A>G , 12S rRNA 1494C >T and 1555A >G)were detected by matrix assister laser desorption/ionization time-of-flight mass spectrometry ( MALDI-TOF-MS ).The features of molecular epidemiology of deafness predisposing genes mutations in newborns were studied. Results The deafness predisposing genes screening showed there were 50 carriers in the 1 902 infants.The overall carrier frequency of five mutations of three genes was 2.63%, with 2.90% in males and 2.35% in females.3.51% in Chancheng district, 3.31% in Nanhai district and 3.10% in Shunde district.In different maternal age groups, the carrier frequency was 2.48%, 2.72% and 2.94% respectively.No infant was GJB2 35delG, 176-191del or 12S rRNA 1494C>T carrier, while all carriers of deafness predisposing genes passed the hearing screening. Conclusions The features of molecular epidemiology of deafness predisposing genes in Foshan revealed that there was no apparent difference in gender ratio, regional distribution and maternal age.Hearing concurrent genetic screening can find neonates with late-onset hearing impairment promptly and provide prognostic information for early treatment, which is significant for the optimization of the strategy for pre-deaf.

Clinical analysis on the levels of IL-6 and TNF-α in blood plasma of neonates with intracranial haemorrhage.

LIU Yan-hong, ZHAO Xian-feng, JIA Mei-yun, YAN An-ping

2014, 22(7):  733-734.  DOI: 10.11852/zgetbjzz2014-22-07-21

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Objective To explore the changes and clinical significance of serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in newborns with intracranial hemorrhage. Method The levels of IL-6 and TNF-α blood plasma in 50 neonates with intracranial haemorrhage (case group) and 26 healthy neonates (control group) were detected by ELISA. Results The levels of IL-6 and TNF-α in case group were significantly higher than those in control group (P<0.05);There were significant differences in levels of IL-6 and TNF-α between different amounts of bleeding group (P<0.05). Conclusions Serum levels of IL-6 and TNF-α creases obviously in newborns with intracranial hemorrhage, suggesting that they might be used as reference index in assessing pathogenetic condition and appraising prognosis.

Prognosis research of early rehabilitation on premature infant with risk factors.

YANG Chun-yan, XU Ping

2014, 22(7):  735-738.  DOI: 10.11852/zgetbjzz2014-22-07-22

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Objective To evaluate the effect of early rehabilitation intervention on preterm children of high-risk brain injury in NICU, and to provide a reliable basis for clinical application. Methods A total of 161 preterm children were enrolled from January, 2009 to July, 2012, who were divided into two groups based on parents' voluntary, the intervention group(n=86) and the conventional group(n=75).The intervention group received medicine and early rehabilitation.The control group received medicine and family invention.Neonatal Behavioral Neurological Assessment (NBNA) scores were assessed in correct gestational age 40 weeks.Early motor development assessed in 3 and 6 months old.Developmental evaluation were performed in 6 and 12 months old. Results There was lower incidence of complications of multi-organs in invention group (P=0.01).There were significant in Infant Neurological International Battery (Infanib) in 3 and 6 months old (all P<0.05).The developmental quotient (DQ) and mental index(MI) of 6, 12 months old infants in the invention group were higher than those of the control group (P<0.01).The incidence of sequelae was lower in intervention than conventional group (11.3% vs 27.2%)(χ²=3.98, P<0.05). Conclusions Early rehabilitation can promote developement of premature infant with brain damage, reduce the sequelae in NICU and the incidences of complication, shorter the hospital stays.

Analysis of screening result and therapy for congenital hypothyroidism in Ankang.

LIANG De-wu, MU Hong-mei, ZHANG Ling, REN Zi-lan, LI Xia, JIANG Jia-yan, LIU Feng, DU Yun-yun, LIU Xiao-ying

2014, 22(7):  739-741.  DOI: 10.11852/zgetbjzz2014-22-07-23

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Objective To know the early screening, positive cut-off value and treatment of congenital hypothyroidism (CH) in Ankang city, and to evaluate the efficacy. Methods The neonates in Ankang from June 2010 to December 2012 were screened for CH, the positive cases were recalled for confirm diagnosis by detecting the serum thyroid stimulating hormone (TSH), FT4 by an automated immunoassay analyzer.The results of TSH in concentration dried-blood spot specimens on filter paper were analyzed by statistical methods to determine positive cut-off value of TSH.The children with CH were followed up by receiving levothyroxine, baby length, weight, and head circumference at 6 months and 12 months of first filial generation were measured, after treatments.Then the infants' intelligence was evaluated respectively in the 12th months and compared with those in normal children. Results A total of 54 306 newborns were screened, screening ratio equaled to 81.38%, and recall rate of 91.18%, diagnosed with hypothyroidism in 32 cases, the total incidence of 1/1 697.The positive cut-off value of TSH for screening of CH of newborn in Ankang city was 7.8 μU/mL.After treatment, all the patients' development and intelligence got the normal level (P>0.05).None of 28 cases who had reached the age of 1 had mental retardation, all the patients were discharged.The rate of some domain on the development state of marginalization was slight high. Conclusions There are high incidence in CH in Ankang city.Timely, effectively and safely treatment and instruction as follow on the children diagnosed with hypothyroidism can improve the outcome instruction.The TSH positive cut-off value of CH screening in Ankang city should be adjusted to 7.8 μU/mL, to reduce missed diagnosis.

Study on neonatal congenital hypothyroidism prevalence trend in Beijing.

ZHANG Bo-xin, LI Xiao-fang, YU Yi-zhen

2014, 22(7):  742-745.  DOI: 10.11852/zgetbjzz2014-22-07-24

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Objective To analyze the change and trend of prevalence of congenital hypothyroidism(CH), and to provide scientific support for the establishment of reasonable strategy and measure for the prevention of CH. Method The information from neonatal screening program during 1994-2011 in Beijing were made by descriptive analysis and statistical inference. Results The prevalence rate of CH showed upward trend in Beijing during 18 years, the average prevalence rate was 31.80/10⁵.In 2003 the laboratory method of CH had been changed from RIA to time-resolved fluorescence immunoassay.which maybe led to the upward trend of the prevalence rate of CH in Beijing. Conclusion The prevalence rate of CH shows upward trend in Beijing during 1994-2011.

Analysis of Guangxi suspected positive congenital hypothyroidism newborn recall and countermeasure.

LUO Chao, CHEN Shao-ke, HUANG Ying, WEN Juan, LI Wang, LIN Cai-juan, FENG Shi-han, YU Jin-wu, GENG Guo-xing

2014, 22(7):  746-748.  DOI: 10.11852/zgetbjzz2014-22-07-25

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Objective To analyse suspected positive congenital hypothyroidism newborn recall of Guangxi, and analyse the reasons of refusing to recall, in order to increase recall rate. Methods The results of recall for CH in Guangxi newborn screening center 2012-2013 were analyzed.All dried blood spots of cooperation hospital were screened TSH concentration.Telephone recalled the suspected positive as soon as possible, the diagnosis was made by testing serum concentration. Results A total of 488 519 newborns were screened in Guangxi 2012-2013, 6 559 were recalled during 7 777 suspected positive, 321 were confirmed CH, the prevalence was 1/1 522.Different screening results and living district had difference in recall rate (P<0.05), different gender and hospital had almost the same recall rate (P>0.05), the major reason of refuse to recall was the finance problem. Conclusion The geographical factor and knowledge of newborn screening in Guangxi is significant limit to cover rate and recall rate.

Epidemiological survey of asthma in children aged 0~14 years old in the Tongan district of Xiamen, China.

CHENG Fei, CHEN Mei, ZHONG Sheng-hui, LV Wen-qing, XU Zhi-xiang

2014, 22(7):  749-751.  DOI: 10.11852/zgetbjzz2014-22-07-26

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Objective To investigate the prevalence rate and risk factors for asthma in children who were aged from 0~14 years old of Tongan district of Xiamen in 2012-2013, and to provide scientific evidence for the prevention and treatment of childhood asthma. Methods A multistage stratified cluster sampling survey of 10 168 children aged 0~14 years old from the Tongan district of Xiamen was conducted to investigate the prevalence rate of childhood asthma using the Third National Childhood Asthma Epidemiological Questionnaire 2010.A case-control study (1∶1) and logistic regression analysis were used to investigate the risk factors for childhood asthma. Results Of the 10 168 children surveyed, 428 were diagnosed with asthma, with a total prevalence rate of 4.21%.The prevalence rate was higher in males than in females (5.88% vs 2.28%, P＜0.01).Of the 428 cases, 74.76% had their first asthma attack before the age of 3, 85.61% suffered from asthma caused by respiratory infection, 95.20% had sneezing as the sign of oncoming attack, 68.25% had mild attacks, 78.50% had sudden attacks, 50.60% suffered from asthma during periods of seasonal change, and 71.45% had attacks at early morning and night.The case-control study ( including the 428 asthma cases and 428 healthy children) and Logistic regression analysis both showed that the independent risk factors for asthma in children include:a personal history of allergy, allergic rhinitis, a family history of allergy, and a family history of asthma. Conclusions The prevalence rate of asthma in children aged 0~14 years old in the Tongan district is higher than that of the prevalence rate in Xiamen 10 years earlier.The prevalence rate of childhood asthma is higher in males than that in females.A personal history of allergy, allergic rhinitis, a family history of allergy and a family history of asthma are the independent risk factors for childhood asthma in this region.

Epidemiology characteristics of hand foot mouth disease in Hainan Province, 2011-2012.

CHEN Shao-ming, QIU Li, JIN Yu-ming, DU Zhong-hua, LI Dan-dan, CHEN Hai-yun

2014, 22(7):  755-757.  DOI: 10.11852/zgetbjzz2014-22-07-28

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Objective To analyze epidemiological characteristics of hand foot mouth disease (HFMD) in Hainan province, and to provide the scientific basis for its prevention and control. Method The data of HFMD were collected from Chinese Disease Surveillance System and etiology detection results of HFMD were analyzed with descriptive epidemiological methods. Results A total of 50 716 HFMD cases, including 976 severe cases and 33 fatal cases, were reported in Hainan in 2011.The reported incidence was 584.86/10⁵ in 2011.A total of 47 715 HFMD cases, including 512 severe cases and 8 fatal cases, were reported in Hainan in 2012.The reported incidence was 543.83/10⁵ in 2012.There were two peaks of the incidence, from April to July (March to May) and from September to November.Most of cases were children aged<5.There was the highest incidence rate in the age group of 1~2 years(13 766.25/10⁵).The gender ratio was 1.79∶1.Most of cases lived sporadically.The proportion of EV71 strains in severe cases and fatal cases was higher than mild cases.The ratio of severe HFMD cases was increased with the proportion of EV71 strains(r=0.601, P=0.000). Conclusion Hainan province is the high prevalence area.Carrying on etiology surveillance, strengthening the prevention and control measure on the main groups and the key site are the main strategies for management of the disease.

Diet intervention for phenylketonuria and the children's intelligence.

WEN Zhuo-yu, HUANG Yan-ping, LI Feng-xia

2014, 22(7):  758-759.  DOI: 10.11852/zgetbjzz2014-22-07-29

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Objective To discuss the early diagnosis and early treatment for phenylketonuria (PKU). Methods Retrospective study and contrast the new chosen sick children who were made a definite diagnosis to those who were delayed to be treated (because of other reasons to come to Shaanxi Maternal and Child Care Service Centre and be diagnosed as PKU).The sick children with better dependency were contrasted to those who had worse dependency. Results The ratio of the new chosen sick children and those who were delayed to be treated, had significant difference(P<0.05).The ratio of the sick children with better dependency and those with worse dependency had significant difference too(P<0.05). Conclusions Screening newborns, having early diagnosis and early treatment are the key ways, because the little the child is, the higher the intelligence quotient (IQ) is.Right guidance, cooperation of the parents and children and the support of the society are the most important measures to ensure the curative effect.

Correlation and clinical application of molecular genetic testing in children with bronchiolitis and asthma.

QU Wen-jing, QI Shu-ping, LIN Jian-juan

2014, 22(7):  763-765.  DOI: 10.11852/zgetbjzz2014-22-07-31

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Objective To investigate the molecular genetics of bronchiolitis and asthma in test and clinical applications. Methods A retrospective compliant 120 cases of hospitalized children in hospital from November 2012 to April 2013 were diagnosed as "bronchiolitis".Children admitted to hospital were underwent genetic testing of children with allergic asthma, according to test results, the number of wheezing and high risk detection was analyzed. Results 1)The first incidence of bronchiolitis children with allergic asthma genetic testing genetic risk was significantly lower than the second incidence of bronchiolitis in children, there was significant difference (P<0.05).2)Children of treatment group were received the appropriate anti-asthma therapy, while the control group were treated with conventional therapy (bronchiolitis treatment), the cough, wheezing, dyspnea and pulmonary rales disappeared time and subsequent episodes, hospitalization time, economic costs and family pressure of the treatment group were significantly lower than those of the control group(P all <0.05). Conclusion Genetic testing for children allergic asthma of capillary bronchitis infants indicates the risk of disease from the genetic perspective, and asthma intervention treatment to high genetic risk assessment of infants and young children achieves the goal of lower disease risk.

Analysis of multi-pregnancies results on congenital hypothyroidism neonatal screening and suggestion about recall-back mode.

JIANG Xiang, LI Bei, JIA Xue-fang, CHEN Qian-yu, LI Hui

2014, 22(7):  766-767.  DOI: 10.11852/zgetbjzz2014-22-07-32

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Objective To study the relationship of congenital hypothyroidism screening results with multi-pregnancies in newborn infants. Methods Detection of thyroid stimulating hormone (TSH) concentration from blood specimens dried on fliter paper by Fluorescence Enzyme Immunoassay (FEIA).The neonates were divided into two groups according to multi-pregnancies, and the correlation was analysed between prevalence of CH and different pregnancies. Results A total of 424 472 infants were screened, and 194 cases were identified with CH.The prevalence rate was 1/2 188.The prevalence of singletons, multi-pregnancies were 1/2 237, 1/652 respectively.The prevalence of CH was significantly different between singletons groups and multi-pregnancy groups. Conclusions The prevalence of CH is associated with multi-pregnancies.In case of missed diagonosis of CH, it is strongly recommendable to recall them back if one of each multi-pregnancies results was positive.

Study on relationship of s-NSE and different serum indexes in neonates with hyperbilirubinemia.

CHEN Bao-chang, DAI Lan-fen, REN Chang-jun, ZHANG Jing

2014, 22(7):  771-772.  DOI: 10.11852/zgetbjzz2014-22-07-34

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Objective To explore relationships of serum neuron-specific enolase (NSE) and serum bilirubin, albumin and B/A values, in neonates suffering from hyperbilirubin-induced brain injury. Methods Serum NSE contents (s-NSE)of hyperbilirubinemia infants were determined by ELISA.Serum indirect bilirubin values (s-UCB) and albumin values (A) were measured by full-automatic biochemical analyzerm, and indirect bilirubin and albumin ratio (B/A) was calculated.The 62 cases with increased s-NSE concentrations were devided into two groups:mildly increased s-NSE values group and highly increased s-NSE values group, then differences of serum indicators from the two groups, and correlations of s-NSE values and the serum indicators were analyzed. Results There were significant difference in s-UCB value (P<0.05), no significant difference in A values (P>0.05), and very significant difference in B/A value (P<0.001) between two groups.There was a good positive correlation between s-NSE value and the B/A value (r=0.687, P<0.001). Conclusions B/A ratio could be a good mark to hyperbilirubin-induced brain injury.Through monitoring B/A ratio, neonates with hyperbilirubinemia may reasonably be intervened.

Analysis of risk factors of 550 small for gestational age newborns.

LI Ping, ZHONG Xin-qi, LIANG Shao-zhen

2014, 22(7):  773-775.  DOI: 10.11852/zgetbjzz2014-22-07-35

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: Objective To explore risk factors of small-for-gestational-age (SGA) births excluding mother's critical basal disease and obstetric risk factors. Methods A total of 550 SGA and 720 appropriate gestational age newborns were analyzed.Mother's stature, body weight, passive smoking and previous abortion or preterm history were collected and stepwise multivariable logistic regression model was constructed for the outcome. Results Risk factors to SGA were pregnant women with low pre-pregnancy body mass index (<18.5 kg/m², OR=2.16, 95%CI:1.53~3.16), short stature (<155 cm, OR=2.46, 95%CI:1.78~3.48), low weight gain during pregnancy (<9 kg, OR=1.92, 95%CI:1.56~2.58) and passive smoking during pregnancy(OR=2.24, 95%CI:1.65~2.98).Pre-pregnancy BMI>24(OR=0.59, 95%CI:0.42~0.86)and weight gain during pregnancy >18 kg(OR=0.62, 95%CI:0.43~0.86)were protective factors of SGA. Conclusion Excluding known clinical risk factors, pre-pregnancy and pregnancy nutrition should be enhanced to add pregnant woman body weight, and protect them from passive smoking environment to reduce the prevalence of SGA.

Study on sialic acid levels in breast milk collected from early neonate's mother.

JIN Yu-ting, RUAN Li-li, HUA Chun-zhen

2014, 22(7):  776-778.  DOI: 10.11852/zgetbjzz2014-22-07-36

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Objective To study the sialic acid (SA) levels in breast milk collected from early neonate's mother, and provide the scientific basis for early breast-milk feeding in neonate especially in pre-term neonates. Methods A total of 284 breast milk samples were collected from 122 early neonate's mothers at the 1^st, 4^th and 6^th days after delivery.The SA levels in breast milk were tested with neuraminidase assay method, the statistical analysis software, SPSS version 17.0 was used in the study.Independent sample T test was used to compare SA levels between groups and Pearson correlation analysis method was used to analyze correlation. Results The mean SA levels in the 1^st day breast milk was (208.6±71.6)mg/dL, which was significantly higher than that in the 4^th day breast milk [(140.4±36.6) mg/dL;t=8.100, P<0.001] and the 6^th day breast milk [(139.3±37.8) mg/dL;t=8.089, P<0.001], however, no difference was found between the 4^th day and 6^th day breast milk(t=0.197, P=0.844).A strong negative correlation between SA levels in breast milk and days after delivery in women was identified, however, no correlation was found between SA levels and birth weights or gestational ages. Conclusion The SA levels is the highest in the 1^st day breast milk and SA levels in brest milk are strongly correlated with the days after delivery in women.

Intervention effect of the health education path on common pediatric asthmatic diseases of children.

LI Hai-bo, LI Xin, LI Li, YAN Xiao-yan, SUN Hui

2014, 22(7):  779-781.  DOI: 10.11852/zgetbjzz2014-22-07-37

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Objective To explore the application effect of the health education path in common pediatric asthmatic diseases of children, and provide a scientific basis for improving and promoting the health of children. Methods A total of 200 children were randomly divided into intervention and control groups during the period from January to June, 2013.The intervention group were treated by the health education path, while the control group treated by the traditional way of health education.And the effect of the two groups was compared. Results The results of hospitalization of children in the intervention group (5.52±1.26)d was shorter than the control group (6.53±1.29)d, inhalation method score (7.00±1.84) was higher than the control group (5.90±1.98).Mental status (38%) was better than the control group (25%), knowledge level of the parents of children (52%) was higher than the control group (18%), nursing satisfaction (80%) was also higher (65 %) than control group (P=0.000). Conclusion The application effect of the health education path in common pediatric asthmatic diseases of children is obvious, and improving the health of children.

Use of noncycloplegic autorefraction for myopia screening in 4~6-year-old children with poor eyesight.

DAI Yin-yan, SHEN Bin, XIA Qing-hua, CAI Wei, ZHU Jian-feng

2014, 22(7):  782-784.  DOI: 10.11852/zgetbjzz2014-22-07-38

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Objective To analyze the difference between the spherical equivalent (SE) before and after cycloplegia in preschool children and explore the effectiveness and feasibility of noncycloplegic autorefraction (NCAR) for large-scale myopia screening in children. Methods A cluster sampling method was used to select children aged 4 to 6 from 35 kindergartens in Changning district.The visual acuity (VA) and noncycloplegic autorefraction were measured in every child and cycloplegia autorefraction was measured in children with poor eyesight.Statistical analysis and linear regression analysis were conducted.The best positive cutoff points and their corresponding sensitivities and specificities for NCAR were also explored. Results SE was more positive after cycloplegia with statistical significance than that before cycloplegia, the linear correlation was proved between the SE before and after cycloplegia.When using NCAR to estimate myopia, the best positive cutoff point was SE less than -1.00D in children aged 4 years old and SE less than -0.75D in children aged 5~6 years old, respectively. Conclusion NCAR is an effective and feasible method for large-scale myopia screening in preschool children.