Table of Content

10 November 2017, Volume 25 Issue 11

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The influence of premature rupture of membrane on fetal-neonatal health and its management

LIU Jing

2017, 25(11):  1081-1085.  DOI: 10.11852/zgetbjzz2017-25-11-01

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Premature rupture of membrane (PROM) is one of the most common clinical issues in pregnancy periods,which can result in all kinds of damages to fetal-neonatal health,especially leading to lung underdevelopment and infectious diseases,even worse,like fetal death and increased neonatal mortality.This paper will introduce the harmful influence of PROM on fetal-neonatal health and management,so as to improve the fetal-neonatal prognosis.

Effects of hypertension on fetus and newborn during pregnancy

ZHENG Jun,WANG Xiao-peng

2017, 25(11):  1086-1089.  DOI: 10.11852/zgetbjzz2017-25-11-02

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The pregnancy-induced hypertension syndrome is a kind of common idiopathic disease.It is also one of the important factors influencing fetal and neonatal growth.Placental function loss caused by pregnancy-induced hypertension syndrome can lead to fetal intrauterine growth retardation,stillbirth,or premature delivery,asphyxia,and other complications,and have damage to the newborn organs.Active using of antihypertensive drugs can lower the pregnant woman blood pressure,but also has potential risks for fetuses and neonates.Therefore obstetrician and pediatrician should pay enough attention to hypertension,regular antenatal examination,early detection and prevention of pregnancy-induced hypertension.Also assessment of the impact on the fetuses and neonates,should be conducted in order to lower the adverse effects of fetuses.

Observation of physical and neurological development in infancy of premature infants of gestational age less than 34 weeks and with exposure to chorioamnionitis

WANG Xing-xing,DIAO Yuan-nan,CHEN Qiang,XIE Yong-li,SHAN Ruo-bing

2017, 25(11):  1090-1093.  DOI: 10.11852/zgetbjzz2017-25-11-03

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Objective To investigate the effect of chorioamnionitis on physical and neurological development in infancy of premature infants with gestational age less than 34 weeks. Methods A total of 41 premature infants with exposure to chorioamnionitis (group A) and 37 premature infants without exposure to chorioamnionitis (group B) of gestational age less than 34 weeks followed up for 12 months after discharge from Qingdao Women and Children's Hospital were enrolled in this study.33 mature healthy infants (group C) were randomly selected from the department of child healthcare.Differences of physical growth indexes,mental development index(MDI),motor development index(PDI)and neural motor development in infancy of the three groups were compared. Results 1)The weight and length development of group A and group B lagged behind those of group C at corrected age of 6 month (P＜0.05).The length development of group B lagged behind that of group C at corrected age of 12 months (P＜0.05).2)The MDI,PDI in group A were lower than those in group B and group C at corrected age of 6 month (P＜0.05);There was no significant difference in MDI,PDI among three groups at corrected age of 12 month(P＞0.05).The incidence of abnormal results in the 20 items of neuromotor assessment in group A and group B was higher than that in group C at corrected age of 6 months and 12 months (P＜0.05). Conclusion Premature infants with gestational age less than 34 weeks exposed to chorioamnionitis are more likely to develop physical and mental retardation in infancy.

Clinical analysis about 2 789cases of congenital hypothyroidism

YANG Ru-lai,TONG Fan,XU Yan-hua,ZHAO Zheng-yan

2017, 25(11):  1094-1097.  DOI: 10.11852/zgetbjzz2017-25-11-04

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Objective To study the cut-off value of screening congenital hypothyroidism (CH),and to analyze the different clinical features prognosis and influencing factors of permanent congenital hypothyroidism (PCH),and transient congenital hypothyroidism (TCH). Method A total of 2 789 cases of CH were enrolled in this research.Clinical data of newborn CH,diagnosed and followed-up in the neonatal screening center from August 1999 to April 2013,were collected retrospectively.The incidence,screening TSH values and complications of CH were assessed.According to whether the cases stop L-Thyroxine at 2 or 3 years old,participants were assigned into two groups:PCH group (n=682) and TCH group (n=621).The clinical features,prognosis,prognosis relevant factors were studied comparatively to PCH and TCH.And the clinical features of preterm CH and low-birth-weight newborn CH were also described. Result The neonatal screening incidence of CH was 1/1 886 in this study,the screening TSH level≥10 mU/L accounted for 97.5% cases.The 682 cases of PCH and 621 cases of TCH were diagnosed.The radio of male/female,mean screening TSH value and inital dosage of PCH group were higher than those of TCH group (4.44∶1 vs 1.14∶1 and 96.4±82.3 mU/L vs 46.8±46.0 mU/L,respectively,P<0.01).While the infant's age of serum FT4 values recovered,and the normal percentage of stature,bone age,DQ or IQ assessment of PCH group were lower than those of TCH group [(57.8±16.4) d vs (68.2±75.7) d,87.9% vs 99.0%,92.9% vs 96.7% and 95.1% vs 98.4%,respectively,P<0.01].117 (PCH 22.2%) cases of preterm CH and 111 cases (PCH34.2%) of low-birth weight newborn CH were found.56 cases (8.2%) in PCH group reused L-Thyroxine during followed-up.The complicated incidence in 2 789 cases of CH was 2.1%. Conclusion The recommended cut-off value in screening CH is >9 mU/L.The outcome of TCH was better than that of PCH.The high level of TSH level implies PCH.Preterm CH and low-birth-weight newborn CH need to be treatedstandard.CH cases need long-term following-up and systemic examination.

Survey on dental caries of children under 7 years old in nine cities in 2015 and its relationship with physical growth

ZHANG Ya-qin,YU Yang,WU Hua-hong,ZONG Xin-nan,LI Hui

2017, 25(11):  1098-1100.  DOI: 10.11852/zgetbjzz2017-25-11-05

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Objective To describe the prevalence of dental caries of children under 7 years old and its secular trend,and to analyze the relationship between dental caries and physical growth. Methods Subjects were from the national survey on physical growth and development of children under 7 years old in nine cities in 2015 (NSPGDC),whose primary teeth had been erupted.Dental caries and growth measurements were obtained in the field.The independent t-test was used to compare the difference of physical growth between children with and without dental caries.Moreover,the data of dental caries in NSPGDC in 1985 and 1995 were used to analyze its secular trend. Results 1) The prevalence of dental caries increased with chronological age,which was from 0.2% at 6~12 months group to 0.9% at 1 year group,to 45.7% at 6~7 years old group.2) The prevalence of dental caries in suburban children was higher than that in urban children and it was also higher in children from northern and southern region than that in central region.3) The differences of weight,length and body mass index between two groups with or without dental caries were not statistically significant for children under 3 years old (P>0.05),while,the three indicators in children aged 3~7 years old were lower in children with dental caries.4) From 1985 to 2015,the prevalence of dental caries became lower.Taking the 6~7 years old group in urban areas as an example,it was 68.1% in 1985 and 43.2% in 2015. Conclusions The prevalence of dental caries become higher and higher with chronological age and there is urban-suburban and regional difference.The relationship between dental caries and physical growth are more significant in children over 3 years old.And the prevalence of clental carries in nine cities is in decline.

Vitamin D status and influencing factors of junior school students in Harbin City

DAI Qian-qian,GAO Peng,YUAN Hong-wei,SHAN Ling-ling,LI Lei,YANG Fang,WANG Qiu-yi, ZHANG Sima-kang,LI Xin-tong,YANG Hui,ZHANG Shi-cheng,ZHANG Yan,WU Li-jie,ZHANG Hui-ying,MA Jun

2017, 25(11):  1101-1104.  DOI: 10.11852/zgetbjzz2017-25-11-06

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Objective To describe the prevalence of vitamin D (Vit D) deficiency in adolescents in Harbin city,and to analyze the influencing factors,in order to provide theoretical basis for Vit D deficiency intervention in adolescents from local area. Methods The level of serum Vit D was measured and questionnaires were filled out by students of grade 6~8 in a middle school of Harbin City. Results A total of 565 middle school students were enrolled in this study.The level of serum 25-(OH)D was (15.25±6.98) ng/ml,the prevalence of Vit D severe deficiency,deficiency,insufficiency and sufficiency were 19.47%,62.12%,16.28% and 2.12% respectively.Demographic characteristics analysis showed that students who were girls or lower age,or lower parents education level had lower serum 25-(OH)D levels and higher Vit D deficiency prevalence,and the differences were statistically significant (P<0.05).Analysis of the source of Vit D showed that 25.31% of students had daily extra Vit D supplements,but only 18.18% took more than 600 U/d; 36.46% of students had daily milk drinking more than 250 ml; 74.87% of students did daily outdoor activities more than 30 minutes.Students with frequent milk drinking,more milk intake and longer daily time activities outdoors had higher serum 25-(OH)D level,and the difference was statistically significant (P<0.05).Multiple linear regression analysis showed that male students,elder age students,students with higher education level of parents and longer daily time activity outdoors had higher serum 25-(OH)D level. Conclusions The status of Vit D deficiency in adolescents in Harbin city is serious,and the influencing factors are complex.It is urgent to take effective measures to improve the regional epidemic status of Vit D deficiency.

Survey on growth development status among 752 migrant children of Hongshan district in Wuhan city

ZENG Jing,LI Yong-jun,ZHANG Bo-xuan,ZHAO Si-qi,LIU Han,CHENG Guang-wen

2017, 25(11):  1105-1107.  DOI: 10.11852/zgetbjzz2017-25-11-07

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Objective To study growth development status of migrant children in Hongshan district of Wuhan city,and to provide scientific basis for promotion of their physical development. Methods Totally 752 students aged 9~12 from two primary schools in Hongshan district of Wuhan were selected by cluster sampling.Based on monitoring data from migrant children's constitution,analysis of the growth development status and comparision with the national physique survey data were carried out. Results The average height in migrant children was lower than that in national children,and differences on height in each group were statistically significant (P<0.05).The average weight of 9~10 years old boys and 9 years old girls in migrant children were lower than those in corresponding groups,and the differences were statistically significant (P<0.05).The detection rate of emaciation among migrant boys were higher than that in national boys of rural and urban,while the rate among girls were lower.The detection rates of overweight and obesity in migrant boys were close to those in national urban boys,and the rates of girls were higher.Moreover,the detection rates of emaciation,overweight and obesity were higher in migrant boys than those in migrant girls,and the gender differences in 11 aged groups existed (P<0.05). Conclusion The growth development level of urban migrant children is below the average level of national children,and malnutrition situations of migrant boys are more serious than that of migrant girls.

Prevalence of overweight and obesity among children and adolescents aged 6~17 years in urban region of Jinan

YANG Li-li,XI Bo

2017, 25(11):  1108-1112.  DOI: 10.11852/zgetbjzz2017-25-11-08

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Objective To describe the prevalence of overweight and obesity among children and adolescents aged 6~17 years in urban region of Jinan using the national and international criteria,and to provide basic data for local government and education department to develop obesity prevention strategies. Methods Data were from the Twelfth Five-year National Science and Technology Support Program "Early Warning,Diagnosis and Treatment of Cardiovascular Disease in Children" conducted from September 2012 to September 2014 in Jinan.A total of 7 840 children and adolescents aged 6~17 years were included in present study.The prevalence of overweight and obesity was determined using criteria of the China,American Centers for Disease Control and Prevention (CDC),International Obesity Task Force (IOTF) and World Health Organization (WHO),respectively.The consistency between the national and international criteria was assessed using the weighted kappa statistic (kw). Results The prevalence of overweight among children and adolescents aged 6~17 years in urban region of Jinan was 21.0% (China),17.2% (CDC),21.0% (IOTF) and 22.1% (WHO),while the prevalence of obesity was 19.9% (China),17.4% (CDC),12.4% (IOTF) and 18.6% (WHO),with boys being significantly higher than girls,and those aged 6~11 years significantly higher than those aged 12~17.In this study,there was high consistency of the China criteria with the CDC,IOTF and WHO references (kw=0.88,0.80,0.91). Conclusions The prevalence of overweight and obesity among children and adolescents in urban region of Jinan is greatly high,especially in boys and children aged 6~11years.It is urgent for the local government to take measures to control childhood obesity.

Study of parents' cognition on the body shape of low grade students' from primary school in urban Guangzhou

LIU Wei,LIN Rong,XIONG Li-hua,CHEN Si-yu,LIN Lin,GUO Chong-shan,LIU Wei-jia

2017, 25(11):  1113-1116.  DOI: 10.11852/zgetbjzz2017-25-11-09

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Objective To study the status of parents' cognition of low grade students in primary school in urban Guangzhou,and to provide new ideas for the development of interventions to control childhood obesity. Methods The height and weight of 3 889 students from Grade 1 to Grade 2 were measured and the body mass index (BMI) was calculated.At the same time,questionnaire surveys were conducted in parents' cognition on the body shape of their children. Results The rates of thin,overweight and obesity were 17.79%,6.69% and 5.86% respectively; 75.03% of the parents were not satisfied with children's body image.The overall adjusted mean of body dissatisfaction score was -0.14,the phenomenon of underestimated children's body existed,especially in son (-0.25) and children in Grade 1 (-0.21). Conclusions Parents of children in Grade 1 to Grade 2 in urban Guangzhou have an obvious underestimation of their children's body,and it is possible to reduce childhood obesity by improving the accuracy of parents' cognition of their children's body.

Effect of Shenfu injection on the expression of placental growth factor in neonatal rats with hypoxic-ischemic brain damage

YANG Qian-qian,WANG Jun,XU Yan,LIU Wen-qiang

2017, 25(11):  1117-1120.  DOI: 10.11852/zgetbjzz2017-25-11-10

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Objective To analyze the expression changes of placental growth factor(PLGF) in neonatal rats with hypoxic-ischemic brain damage,and to discuss the possible roles of PLGF in alleviating cerebral ischemia,promoting regeneration of blood vessels as well as the protective effects of Shenfu injection on the expression of PLGF. Method All the neonatal rats were randomly divided into three groups:sham operation group (S),Shenfu injection treatment group (SF),and saline control group (C).They were further divided into five subgroups(n=8 per subgroup) according to the time points:6 h,12 h,1 d,3 d,7 d.Models of postnatal 7-day Sprague Dawley rats with HIBD were established with Rice methods.Group SF was treated with Shenfu injection (10 mg/kg,ip) immediately after hypoxic-ischemic brain damage (HIBD).The injection lasted for three days once a day at the same time.Group C was treated with saline in the same way with the same dosage.There was no treatment with any drugs in Group S.RT-PCR and immunohistochemistry method were used to detect the changes of PLGF in the lesion side cerebral cortex in neonatal rats. Results Expression of PLGF in group S was the same at different time points(P>0.05); In group C,the expression of PLGF started to increase at 6 h,and reached a peak at 1 d and then gradually declined.The expression level was higher than S group from 12 h to 7 d(P<0.05);In SF group,the expression increased before 6 h,and the tendency of expression was similar to C group;However it had a more obvious decline at 3 d.The whole level was apparently higher than S and C groups. Conclusion The expression levels of PLGF increase highly after hypoxic-ischemic brain damage,and Shenfu injection can protect the brain from damage effectively through facilitating the expression of PLGF.

Influences of several common maternal diseases on the fetuses and neonates

ZOU Xin-fei,FANG Xiao-yi

2017, 25(11):  1121-1124.  DOI: 10.11852/zgetbjzz2017-25-11-11

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Pregnant woman provides suitable nutrition and growth environment for the fetuses.Any abnormality of the mother during pregnancy may cause adverse outcomes of fetuses and neonates in perinatal period.The progression of the maternal disease can be prevented if it's identified and managed at the early stage,as a result,the outcome of the fetuses and neonates might be improved.The influences of several common maternal diseases on fetuses and neonates are reviewed so as to initiate the interests of the obstetricians and neonatologists on maternal diseases.

Effects of pregnancy induced hypertension and pre-eclampsia on the newbron and suggeated management

BAI Rui-miao,LI Zhan-kui

2017, 25(11):  1125-1127.  DOI: 10.11852/zgetbjzz2017-25-11-12

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Hypertensive disorder complicating pregnancy (HDCP) occurs during pregnancy,and its severe complications are the major cause of the increasing mortality of maternal and neonates.This article summarizes the effects of pregnancy hypertension on neonatal outcomes,so as to estabilish systematic understanding of the research progress in this area,which is significant for active prevention and treatment of hypertensive disorder complicating pregnancy,thereby reducing the perinatal mortality and improving the prognosis of neonates.

Pro-ADM,sTREM-1 and neonatal infection in preterm premature rupture of membranes

LIU Meng-nan,ZHANG Xiao-jia,JIN Zhen-ai

2017, 25(11):  1128-1130.  DOI: 10.11852/zgetbjzz2017-25-11-13

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In recent years,preterm premature rupture of membranes gradually attracts attention.Due to the relationship between premature rupture of membranes and infection,it is necessary to find not only prediction of the occurrence of maternalpreterm premature rupture of membranes,but also early signs of neonatal infection and its extent.Recent studies have discovered that adrenomedullin precursor and soluble myeloid cell expression trigger receptor-1 (sTREM-1) can help make definitive diagnosis of infection,as well as determine the severity of infection and predict the prognosis.This article will review studies and progress on adrenomedullin precursor,soluble myeloid cell expression triggering receptor-1 and preterm premature rupture of membranes,as well as review related issues.

Research progress on growth regulation of cartilage growth plate

WANG Pan-pan,SHAO Qian,BAN Bo

2017, 25(11):  1131-1133.  DOI: 10.11852/zgetbjzz2017-25-11-14

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Cartilage growth plate (CGP) is mainly composed of chondrocytes and extracellular matrix (ECM).The proliferation,differentiation,hypertrophy of chondrocytes,and the formation of ECM,are the key to the development of bone and linear growth.Therefore,the factors related to CGP that regulation growth mainly include growth hormone-like insulin-like growth factor-1 (GH-IGF-1) axis,various hormones,paracrine factors and inflammatory cytokines acting on chondrocytes and collagen in cartilage ECM,non-collagen glycoprotein,proteoglycan and other ingredients.Previous studies mostly focused on the regulation of GH-IGF-1 axis growth,but other relevant factors on CGP beyond GH-IGF-1 axis that can control the growth receives more concern in recent years.

Research progress on gene copy number variations in the simple congenital heart defects

LI Jing,WANG Yan-xia,MAO Bao-hong,PEI Jian-ying,LIN Xiao-juan

2017, 25(11):  1134-1137.  DOI: 10.11852/zgetbjzz2017-25-11-15

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Congenital heart defects (CHDs) are the most common birth defects in China,whose underlying etiologies of disease remain unknow.More recently,research investigations and clinical diagnostic testing indicated that copy number variations (CNVs) have emerged as an important contributor to congenital genetic disorders,which accounts for approximately 3%~10 % in simple CHDs.However,the full impact of copy number variations (CNVs) as a genetic mechanism in CHDs is not known with certainty.So the research progress of the relationship between CNVs and simple CHDs were summarized in this paper.

Influence of intrahepatic cholestasis of pregnancy on outcomes of pregnancy and neonates by a retrospective study

LIU Xiao-ying,CHEN Rong,XIAO Dong-fan

2017, 25(11):  1138-1140.  DOI: 10.11852/zgetbjzz2017-25-11-16

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Objective To investigate the effect of intrahepatic cholestasis of pregnancy(ICP) on pregnancy outcomes and neonates. Methods A total of 173 pregnant women who were diagnosed with ICP and delivered in gynecology department of Guizhou Provincial People's Hospital were classified as ICP group,and 180 healthy pregnant women were classified as control group from May 2013 to April 2017.Related indexs including maternal age,gravidity,parity,delivery mode,pregnancy outcomes and the neonatal laboratory indexes and diseases were collected and compared between the two groups. Results There was no significant difference on maternal age and times of pregnancy between the two groups,but the times of gravidity and the proportions of cesarean section in ICP group were significantly higher than those in control group (P<0.05);The proportions of low birth weight infants,meconium stained amniotic fluid,and asphyxia in ICP group were significantly higher than those in control group (P<0.05);The levels of TC,ALP and TBA in ICP group were significantly higher than those in control group (P<0.05). Conclusion ICP can cause neonatal birth and postpartum abnormalities,such as low birth weight infants,meconium stained amniotic fluid,asphyxia,and neonatal ALP,TBA abnormalities.

Study on the correlation between exposure to chorioamnionitis or funisitis and common diseases in premature infants

XIE Yong-li,CHEN Qiang,WANG Bo,SHAN Ruo-bing

2017, 25(11):  1141-1145.  DOI: 10.11852/zgetbjzz2017-25-11-17

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Objective To investigate the relationship between chorioamnionitis or funisitis and diseases in preterm infants with gestational age less than 34 weeks. Method A total of 151 premature infants with gestational ages less than 34 weeks were enrolled.According to placental pathology,subjects were divided into CA(-)FV(-)group,CA(+)FV(-)group,and CA(+)FV(+)group.Incidence of diseases and the infection parameters among three groups were compared. Result The incidence of diseases increased with the progress of inflammation,and the incidence rates of pneumonia,respiratory distress syndreme (RDS),intracranial hemorrhage,and necrotizing enterocolitis (NEC) in three groups were significantly different (P<0.05).Prenatal fever,white blood cell count(WBC) of prenatal maternal infection,C reactive protein (CRP) and neonatal calcitonin peptide(PCT)were significantly different (P<0.05).With the increasing of the infection index,tissue type chorioamnionitis and funisitis increased gradually,while the difference of the prenatal N% and infection index of preterm infants was not significant (P>0.05). Conclusion Exposure to chorioamnionitis or funisitis will lead to higher incidence of organ damage in preterm infants of gestational age less than 34 weeks.Also,the incidence rates of pneumonia,RDS,intracranial hemorrhage,NEC are closely correlated with chorioamnionitis or funisitis.The levels of WBC,C reactive protein(CRP) and neonatal calcitonin peptide(PCT)could be an indicator to predict the occurrence of chorioamnionitis or funisitis in preterm infants.

Association between breastfeeding duration and risk of overweight and obesity among preschool children

CAO Ying,ZHANG Ya-lan,LIU Chun-hua

2017, 25(11):  1146-1149.  DOI: 10.11852/zgetbjzz2017-25-11-18

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Objective To analyze the association between breastfeeding duration and the risk of overweight and obesity among preschool children,and to provide guidelines for the prevention of children's overweight and obesity. Methods A total of 3 586 preschool children aged 3~6 years who were vaccinated in the Baoji Maternal and Child Health Care Hospital from August 2015 to December 2016 were included in this study.The data of breastfeeding were obtained by questionnaires.Height and weight were measured.Logistic analysis was performed to evaluate Odds ratio (OR) and 95% Confidence interval (CI) of the risk of overweight and obesity. Results The prevalence of overweight and obesity among the participants were 12.5% and 9.8%,respectively.Breastfeeding duration was negatively associated with the risk of overweight and obesity among preschool children.The risk of overweight and obesity in preschool children who were breastfed not less than 12 months was 0.58 times that of preschool children without breastfeeding. Conclusion Longer duration of breastfeeding may be a protective factor for preventing overweight and obesity in preschool children,indicating that long-term breastfeeding should be promoted.

Duration of breastfeeding and its influencing factors in children from poor areas of Anhui

HUANG Yong-ling,ZHANG WEI-Min,FANG Liang

2017, 25(11):  1150-1151.  DOI: 10.11852/zgetbjzz2017-25-11-19

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Objective To understand the current status and influencing factors of breastfeeding in poor areas of Anhui. Methods Children aged 6 to 24 months were selected as subjects from the program on "Nutritional improvement for children in poor urban areas of China".Kaplan-Meier method was used to estimate the survival curves and Cox multivariate step-wise regression was used to identify the relevant factors on the duration of breastfeeding. Results Median of the duration for breastfeeding was 10 months in poor areas of Anhui.Cox maltivariate step-wise regression showed that factors including mother care,mother's age,exclusive breastfeeding for 4 months or more and using bottle-feeding were correlated with the duration of breastfeeding. Conclusions Duration of breastfeeding for children in poor areas of Anhui is shorter compared with WHO standard.Intervention program should be implemented to improve the current status on breastfeeding in poor areas.

Analysis of the status and influencing factors of breastfeeding in Anhui province

YANG Shu-xin-yi,HONG Qian,SUN Xing-xing,HAO Yu,DENG Yu-chen,DUAN Shu-pei

2017, 25(11):  1152-1155.  DOI: 10.11852/zgetbjzz2017-25-11-20

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Objective To investigate the status and influencing factors of breastfeeding among two-year-old infants in Anhui province,in order to effectively improve the breastfeeding rate in Anhui province and to provide a reliable basis. Methods Using random cluster sampling method,1 019 mothers with 2-year-old children who did regular physical examination were enrolled from nine Streets Community Hospital child health care Branch in three cities,and were investigated by using the questionnaires. Results The rate of exclusive breastfeeding rate within six months reached 61.9% in Anhui province.Breastfeeding rate (64.5%) and mixed feeding rate (31.3%) were the highest in Hefei.Fuyang showed the highest rate of bottle feeding (12.3%).The main reason for choosing bottle feeding was insufficient milk supply.In term of the benefits of breastfeeding,maternal awareness rate in Hefei and Wuhu was significantly higher than that in Fuyang.Multivariate analysis showed breastfeeding rates were related to mother occupation in Hefei and Fuyang,but breastfeeding rates in Wuhu were related to modes of delivery(P<0.05). Conclusions Medical institutions should reduce cesarean section rate,strengthen the publicity and popularization of breastfeeding knowledge by medical staff.Also,prolonging breastfeeding leave and providing maternal and child health room in public places may help to improve the breastfeeding rate.

Risk factors of helicobacter pylori infection in infants and young children in Suzhou city

MENG Yu-mei,KONG Rui,SONG Yuan,WU Qing-bin

2017, 25(11):  1156-1159.  DOI: 10.11852/zgetbjzz2017-25-11-21

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Objective To identify the risk factors of helicobacter pylori (Hp) infection in infants and young children in Suzhou City. Methods A random sample of 441 infants and young children who had regular physical examinations in Child Healthcare Department of Suzhou Municipal Hospital were enrolled as research subjects.Oral Hp infection was diagnosed by method of saliva test board (HPS).Related demographic data were obtained by a structured questionnaire sent to the parents of these children.Categorical variables were analysed with chi-square test in univariate factor analysis.The substantially significant factors were included in Logistic regression analysis. Results Among 441 infants and young children,212(48.1%) were diagnosed as HPS test positive.HPS positive rates in the age periods of 0 months～,6 months～,1 years old～,2～3 years old were 27.6%,56.1%,56.7%,and 63.5% respectively,which meaned obviously that the prevalence increased with age.The following factors were the high risks of Hp infection:complementary foods introduction,age,too much family members,children personal hygiene practices such as chewing fingers,caregivers' children-raising patterns such as chewing and crushing food before feeding and caretaker personal habits (no washing hands before eating) and families' stomach diseases history. Conclusions The main transmission routes of Hp infection are oral to oral and fecal to oral.It makes great sense to use individual plates or serving chopsticks in family,pay attention to hands hygiene (including washing hands before breast feeding and preparing food),educate infants to develop excellent dietary health habits,and improve family living standards.

Study on nutritional status and influencing factors of children under 5 years old in Guiyang

HE Zan-qun,LU Yong-hui,LUO Yan,SUN Yuan,YANG Hui-ping,LIU Shu-qing

2017, 25(11):  1160-1162.  DOI: 10.11852/zgetbjzz2017-25-11-22

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Objective To explore the nutritional status and influencing factors in children under 5 years old,and to establish the foundation of health condition for these children. Methods A total of 4 221 children aged 0～5 years were selected by stratified random sampling in Guiyang.Physical growth was assessed and the participants' parents were surveyed using questionnaires by face-to-face interview.And data were analyzed with SPSS17.0 statistical software. Results The prevalence rates of malnutrition and obesity in children under 5 years old in Guiyang were 7.37%and 2.42%,respectively.The risk factors of malnutrition were associated with living in rural areas,upper respiratory tract infection,non-breastfeeding within six months,independent feeding,frequent snacking and low level of mother education. Conclusions The prevalence rate of malnutrition among children aged 0～5 years in Guiyang is high.An effective intervention strategy should be provided by relevant government and pediatricians.

Analysis of physical examinations in 245 children with Thalassemia parents

LIN Xiang-bin,HAN Zhou-xin,LI Zhi-qin,HUANG Jian-fu,LONG Chang

2017, 25(11):  1163-1165.  DOI: 10.11852/zgetbjzz2017-25-11-23

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Objective To analyze the physical growth situation of the children with thalassemia parents in Hainan rural area,and to promote the health development for children. Methods A total of 245 children with thalassemia parents in Hainan rural area were inquired and made physical examinations.The results evaluated on the exam were compared with the reference standards. Results The prevalence rates of growth retardation,underweight and marasmus in 245 boys and girls were 6.4% vs 24.1%,26.2% vs 9.6%,and 29.8% vs 24% respectively.There was no significant difference on these indexes between boys and girls.There were 3 cases of overweight and no obesity.The overall prevalence rates of growth retardation,underweight and marasmus were 7.8%,26.5%,and 25.3%,respectively.Totally 202(82.4%) children took thalassemia gene.The Hb average value of the medium type of α-thalassemia group was the lowest (87.8±8.7)g/L,with the significant difference of (116.8±16.31) g/L to the Hb average value for no-thalassemia group. Conclusions The prevalence of malnutrition in children with thalassemia parents in Hainan rural area is higher,which is closely related to the severity of anemia and gene deficiency or mutation.Therefore,it is necessary to strengthen the guidance for health promotion in child with thalassemia,and to improve their health growing level.

Analysis of the soft drink consumption and free sugar intake in 6~14 year-old children in Shandong,China

YU Lian-long,JIANG Ying,CHU Zun-hua,WANG Ke-bo,ZHUANG Mao-qiang,XIAO Pei-rui,WANG Lian-sen

2017, 25(11):  1166-1168.  DOI: 10.11852/zgetbjzz2017-25-11-24

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Objective To describe the consumption status of soft drinks and the intake of free sugars in children aged 6~14 years in Shandong province,and to provide a scientific reference for guiding children's soft drinks intake and controlling obesity. Methods In this paper,11 regions including Dongying,Jinan,Jining,Laiwu,Liaocheng,Linyi,Qingdao,Tai'an,Weihai,Weifang and Yantai were selected as the survey points using the multi-stage stratified cluster random sampling method.The investigated survey points were divided into cities and rural population. Results A total of 2 044 children aged 6~14 years in Shandong were surveyed,including 1 039 males and 1 005 females,556 from cities and 1 488 from rural areas.The drinking rates and consumption of carbonated drink of male were higher than those of female (χ²=5.582,t=2.625,all P<0.05).The drinking rates of fruit juice and vegetable juice,coffee or coffee drink and milk drink in female were higher than those in male (χ²=7.588,7.386, 8.252,all P<0.05).The drinking rate of urban children was higher than that of children from rural areas (χ²=4.983,P<0.05).The consumption of yogurt and coffee or coffee in female were significantly higher than those in male (t=-1.980,-2.555,all P<0.05).The consumption of carbonated drink in male was significantly higher than that in female (P<0.05).The consumption of certain types of beverages was higher in urban and rural areas than that in the others (P<0.05).The monosaccharide and free sugar intake of urban children (26.0 g/d,17.1 g/d) were significantly higher than those of rural children (16.9 g/d,11.8 g/d)(t=8.14,5.30,P<0.05). Conclusion The energy consumption of free sugars in children aged 6~14 years in Shandong is not higher than recommended value of World Health Organization,Chinese Diet Guidelines and American Heart Association,but the relative proportion is higher.

Screening results and analysis of retinopathy of prematurity among premature infants in Huzhou area

LEI Zhao-xia,TANG Jian-bo,LOU Zhi-wu,LU Li,LI Jiang

2017, 25(11):  1169-1172.  DOI: 10.11852/zgetbjzz2017-25-11-25

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Objective To analyze the incidence and prognosis of retinopathy of prematurity(ROP) in Huzhou and to find high risk factors for children with ROP in order to provide early intervention. Methods A total of 784 premature children with weight not more than 2 000 g,gestational age under 34 weeks and combined with oxygen inhalation,choking,intrauterine infection,and other critical illness at 34~37 weeks during gestation were enrolled in this study.And eyes were by Retcam. Results The rate of ROP in children was 11.23% among 784 premature children and 13.48% of children with ROP received operation.The morbidity of ROP was related to birth weight(F=58.78,P＜0.01),gestational age (F=24.05,P＜0.01),and lower growth rate within 8 weeks later after birth(F=3.605,P＜0.05). Conclusions Birth weight,gestational age,long-term oxygen inhalation and low postnatal weight gain remain the important risk factors for ROP,and low postnatal weight gain may have no reference to prognostic.The conclusion suggests attention should be paid to the growth and development of the whole body in children patients during ophthalmic screening.

Effect assessment of quality improvement on lactation for very low birth weight infants in NICU

WENG Li,CHU Xue,XUE Hai-hua,ZHANG Jun,CHEN Xiao-hui,LIU Feng,HAN Shu-ping,YU Zhang-Bin

2017, 25(11):  1173-1175.  DOI: 10.11852/zgetbjzz2017-25-11-26

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Objective To compare the effect of breastfeeding quality improvement on the lactation in very low birth weight (VLBW) in the neonatal intensive care unit (NICU) between improvement group and stable improvement group. Methods A retrospective analysis was performed for the lactation of the VLBW mothers and these mother's own milk feeding in NICU.Patients admitted from August 2015 to January 2016 were assigned to the quality improvement group(QI group)and those admitted from February 2016 to July 2016 were assigned to the stable quality improvement group(SQI group).The parameters including condition of daily lactation (daily number of pumping or hand expressing,daily breast milk volume,days to reach the daily milk output ≥350 ml,number of the mothers for reach the daily milk output ≥350 ml in 7 days ),and condition of mother's own milk feeding (the rate and the volume of mother's own milk feeding). Results Compared with the QI group,the daily number of pumpings,daily milk output,and the mother's own milk feeding rate and amount all increased significantly in the SQI group (P<0.05).The mothers in the SQI group significantly shortened the time of daily milk output reaching 350 ml and increased the number of mothers of daily milk output≥350 ml (P<0.05). Conclusion High quality breastfeeding quality improvement measures can increase the condition of the lactation and the mother's own milk feeding for VLBW in the NICU.

Effect of caffeine citrate and aminophylline on clinical efficacy and neurological development in preterm infants with primary apnea

WANG Ling-ling, WEN Xiao-hong, HUANG Jin-hua, WANG Shui-yun, YU mei

2017, 25(11):  1176-1178.  DOI: 10.11852/zgetbjzz2017-25-11-27

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Objective To compare the clinical efficacy of caffeine citrate and aminophylline in the treatment of primary apnea premature infants,and to evaluate the effect of caffeine and aminophylline on children's neurodevelopment. Methods A total of 50 cases with primary apnea using aminophylline treatment were randomly assigned to aminophylline group,and 34 cases using caffeine citrate treatment were assigned to caffeine group.Children in two groups both received regular follow-up in out-patient of high-risk infants.The clinical efficacy of the two groups was compared and BSID was used to assess the neurodevelopment at the corrected age of 6 months. Results The duration of NCPAP,invasive mechanical ventilation,oxygen and treatment in caffeine citrate treatment group was significantly lower than those of amiophylline treatment group (P<0.05),The scores of psychomotor developmental index (PDI) and mental developmental index (MDI) in citrate caffeine group at corrected age of 6 months were significantly higher than those in aminophylline treatment group (P<0.05). Conclusion The effect of caffeine citrate in treatment of primary apnea is better than that of aminophylline,and it has a certain effect on promoting long-term neurodevelopment.

Effect of health education on prevention and treatment of iron deficiency in children

ZHANG Yu-ying,LI Yang,SHI Lei,HAN Hai-feng,SHANG Dong-yang,YANG Fan,GUO Rui-fang

2017, 25(11):  1179-1181.  DOI: 10.11852/zgetbjzz2017-25-11-28

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Objective To explore the effect of health education on children iron deficiency,and to provide a basis for more effective prevention and treatment of iron deficiency in children. Methods A total of 646 children diagnosed with iron deficiency from January 2014 to December 2015 were selected,and randomly divided into the control group and the experimental group(323 cases per group).The control group received traditional health education,while the experimental group received the intersive health education.The awareness rate,re-examination rate,average serum ferritin level and patient satisfaction were compared between the two groups. Results The rates of awareness of disease,drug treatment control,correct method of feeding,poor eating behavior correction,feeding behavior,knowing relevant attention to matters in experimental group were significantly higher than those in the control group (P<0.001).Furthermore,the re-examination rate of experimental group was obviously higher than that in control group (χ²=61.297,P<0.001).Also,the average serum ferritin levels of two groups also had significant differences (U=16.434,P<0.0001),and there was significant difference on patient's satisfaction between the two groups (χ²=44.741,P<0.001). Conclusion The intensive health education can help patients effectively know about the effects of iron deficiency on children health and the drug treatment-related knowledge,realize the importance of regular re-examination and reasonable diet.Consequently,children's bad feeding behaviors and eating habits will be effectively corrected,and the effect of health education and patient's satisfaction will be significantly improved.

External quality survey on quality indicators of neonatal screening for inherited metabolic diseases in China

WANG Wei,ZHANG Xiao-yan,YUAN Shuai,HE Fa-lin,ZHONG Kun,WANG Zhi-guo

2017, 25(11):  1182-1185.  DOI: 10.11852/zgetbjzz2017-25-11-29

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Objective To establish and apply an analysis platform for quality indicators of newborn genetic metabolic disease screening,and to analyze current status of 16 neonatal screening quality indicators in China. Methods According to ISO/IEC 17043:2012 mode 3,a network platform for survey on neonatal screening quality indicators was designed and developed.Electronic questionnaires were distributed to 224 newborn screening laboratories,who were asked to report their 2015 annual statistical data online.The aforementioned platform and SPSS 13.0 were utilized for statistical analysis wherein means,medians,the 5th and 95th percentiles (P₅ and P₉₅) of each quality indicators were calculated. Results A total of 151 screening laboratories submitted their results.The mediums of 5 quality indicators were above 95%,including awareness rates of neonatal screening health education,screening rates,timely turnaround rates of newborn screening samples,timely reporting rates of test results,and practice rates of internal quality control; Whereas the mediums of 4 quality indicators were below 1%,including the percentages of unacceptable dried blood spot samples,the percentages of samples that lacked important information,failure rates of CVs for internal quality control,and loss rates of follow-up cases.Individual quality indicators varied between laboratories,while the rates of quality indicators showed significant distinctions among different diseases.A majority of laboratories rendered a 3~5- day pre-examination turnaround time (TAT),and reporting TAT of test results were mostly within 3 days. Conclusions Newborn screening laboratories were obliged to analyze while monitoring the quality indicators,by participating external quality assessment programs and enhancing the construction of information system,so more reliable and effective quality management can be achieved.