Table of Content

10 March 2018, Volume 26 Issue 3

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Clinical characteristics and advance on diagnosis and treatment of duchenne muscular dystrophy

YANG Ru-lai

2018, 26(3):  233-235.  DOI: 10.11852/zgetbjzz2018-26-03-01

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Duchenne muscular dystrophy (DMD) is an X-linked recessive genetic disease related to muscles,and is mainly treated clinically by glucocorticoid.Early diagnosis and treatment for patients can improve the quality of life and prolong their lives.It is possible to diagnose and give treatment earlier through newborn DMD screening.Meanwhile,recent significant progresses on DMD treatment have been made in terms of medication,gene therapy and bone marrow stem cell transplantation.

Correlation study on catch-up growth span in low birth weight infants and overweight or obesity in childhood

ZHOU Yu-run, CHEN Jie, SUN Jian-le, TANG Han-yan, YANG Xin-jun

2018, 26(3):  236-238.  DOI: 10.11852/zgetbjzz2018-26-03-02

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Objective To analyze the relationship between the early growth stage body mass index (BMI) increasing span and the childhood growth overweight or obesity in low birth weight infants,and to provide scientific basis for the moderate catch-up growth of low birth weight infants. Methods Children born from October 2011 to September 2012 in Wenzhou were selected retrospectively,and were divided into low birth weight group and normal birth weight group.The weight and length datas of two groups of children at the age of one month,1 year old and 5 years old were collected,then BMI in each stage was calculate respectively.BMI distribution interval was divided according to the BMI boundary value point which from《Standards for growth and development of preschool children》of WHO,and BMI increasing span from one month to one year old was got and then analyse the overweight or obesity probability when they were 5 years old with different BMI increasing span. Results In low birth weight group infants whose BMI increases over 3 or more spans was nearly 25% higher than normal birth weight group.There was no significant difference in the incidence of overweight or obesity between the BMI 0 span or 1~2 span in the low birth weight group,but there were differences between the normal weight group in each BMI increasing span.A certain correlation was found between BMI growth span and growth level in low birth weight infants,all one-month to one-year-old infants' body weight,height,and BMI did not reach the median of WHO which that there BMI were in the same interval.Body weight and BMI were higher than WHO reference medians and also had differences when BMI increased to 5 or more spans. Conclusions Compared with normal birth weight infants,more low birth weight infants have a larger increase range of BMI during the critical growth period,BMI growth span in 1~2 intervals is more favorable for controlling growth and overweight or obesity in the future.

Comparison of the performance of waist circumference,waist-height ratio,and body mass index in predicting metabolic disorders among children and adolescents

HOU Ya-ping, YANG Liu, XI Bo

2018, 26(3):  239-242.  DOI: 10.11852/zgetbjzz2018-26-03-03

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Objective To examine the performance of waist circumference (WC),waist-height ratio (WHtR) and body mass index (BMI) for predicting metabolic disorders in children and adolescents,and to provide scientific evidence for early warning of metabolic disorders. Methods A total of 1 170 children and adolescents aged 7~17 years from urban area of Jinan were included in this study.Receiver operating characteristic curve (ROC) analysis was used to compare the area under curves (AUCs) of WC,WHtR and BMI for predicting metabolic disorders.Logistic regression model was conducted to examine obesity defined using WC (≥age- and sex- specific P₉₀),WHtR (≥0.50) and BMI (≥age- and sex- specific obesity cut-offs) respectively,for predicting the risk of metabolic disorders. Results The area under curve value (AUC) of WC for predicting more than one or two of four metabolic disorders (including hyperglycemia,hypertension,lowered HDL-C,and elevated TG) were 0.63 (0.59~0.66) and 0.74 (0.69~0.79),respectively.The corresponding values of WHtR were 0.62 (0.58~0.65) and 0.74 (0.69~0.79),and the corresponding values of BMI were 0.64(0.60~0.67) and 0.75(0.70~0.80),respectively.The odds ratios (ORs) of abdominal obesity defined by WC in predicting ≥1 or ≥2 metabolic disorders were 2.88(2.15~3.86) and 6.83(4.47~10.44),respectively,which were similar with the corresponding values of WHtR[2.63(1.86~3.71) and 5.77(3.65~9.13)],as well as BMI[3.03(2.17~4.23) and 6.35(4.03~10.00)]. Conclusions WC,WHtR and BMI are all important predictors for metabolic disorders in children and adolescents.Considering the similar performance of WC,WHtR and BMI,WHtR may be suitable to replace WC and BMI as an early warning predictor of metabolic disorders in children and adolescents.

Study on the status and influencing factors for eating behaviors of preschool children

DAI Yang, XU Tong, MA Yong-hong, QI Hua-nan, JIANG Xun, SHANG Lei

2018, 26(3):  243-246.  DOI: 10.11852/zgetbjzz2018-26-03-04

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Objective To learn the eating behavior status and influencing factors of preschool period and to provide some references for early intervention of unhealthy eating behaviors among preschool children. Methods A total of 330 preschool children's caregivers from 2 kindergartens in urban and suburban areas of Xi'an were selected by using stratified cluster sampling method from April and June in 2016,and were asked to finish the Preschool Children's eating Behavior Scale.Multiple stepwise regression analysis was used to determine the influencing factors of children's eating behaviors. Results Totally 319 validated questionnaires were got back and the valid answering rate was 97%.The Results suggested that gender,mother's literacy level and family size were major influencing factors for children's fussy eating;only-child and family size were positive associated with food response;gender,mother's literacy level,average monthly income per person and family size had an impact on improper eating behavior;gender,family structure and average monthly income per person were major influencing factors for satiety response;only-child and family size were associated with external eating;only-child,family structure and family size were closely related to emotional eating;age,family structure and family size could influence children's initiative eating. Conclusion Family demographic characteristics can influence preschool children's eating behaviors,but different eating behaviors habit have different influencing factors.

Study about the lifestyle of children with obesity

ZHANG An-yi, LI Sheng-hui, MA Jun

2018, 26(3):  247-250.  DOI: 10.11852/zgetbjzz2018-26-03-05

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Objective To investigate the prevalence of childhood obesity in Chinese children at school age and the influence of bad lifestyle in contributing to childhood obesity. Methods Data were from a sleep survey conducted from November to December in 2005.Lifestyle like eating habits,screen viewing,quality of life,and physical sports were included in our analysis,and Logistic regression analysis was used. Results The general prevalence of obesity in Chinese children was about 10.2%.And univariate Logistical regression showed that the related factors included less friends,long time screen viewing,being blamed by teachers and parents,less physical sport,more caffeine intake.Multivariate Logistic analysis indicated long time screen viewing (OR=1.104,95%CI:1.035～1.178),being blamed by teachers (OR=1.099,95%CI:1.036～1.166),less physical sports (OR=1.096,95%CI:1.050～1.143) and less friends (OR=1.091,95%CI:1.044～1.141) were the risk factors of childhood obesity. Conclusions Parents should pay more attention to the bad lifestyles of the obese Chinese children,and try to avoid these situations.

Feasibility study of screening for congenital heart disease in neonates by using pulse oximetry combined with clinical assessment

HAN Xia, YANG Wen-hong, YU Qian, HUANG Guo-ying, HU Jian-wei

2018, 26(3):  251-253.  DOI: 10.11852/zgetbjzz2018-26-03-06

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Objective To evaluate the feasibility and reliability of screening for congenital heart disease (CHD) in newborn by using percutaneous oxygen saturation detection (POX) combined with clinical assessment. Methods Screening for CHD within 7 days after birth was performed in 62 000 newborns from August,2011 to December,2014 in Kunshan city.The suspected cases were finally diagnosed by Color Doppler echocardiography and were followed up regularly after discharge.Indexes including sensitivity,specificity,positive/negative predictive value and positive/negative likelihood ratio were calculated and compared. Results Among 62 000 newborns,539 cases were diagnosed with CHD.The sensitivity of pox screening combined with clinical assessment of congenital heart disease was 93% (95%CI:86.4%~95.4%),the specificity was 94.3%(95%CI:85.6%~96.0%),and the Youden index was 0.87. Conclusions POX combined with clinical evaluation for screening congenital heart disease is of high sensitivity and specificity.Cunent clinical assessment mainly use heart murmur as a screening tool,which is simple and accurate and is suitable for grassroots units to screen for newborns congenital heart disease screening.

Analysis of the current status of outdoor activity time of Chinese students in 2016

XU Rong-bin, GAO Di, WANG Zheng-he, ZOU Zhi-yong, HU Pei-jin, MA Jun, SONG Yi

2018, 26(3):  254-257.  DOI: 10.11852/zgetbjzz2018-26-03-07

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Objective To investigate the current status of daily outdoor time of Chinese students. Methods Data were extracted from the National Monitoring of Common Diseases and Health Risk Factors among Students finished from September 2016 to December 2016.A total of 146 054 students' questionnaire Results about outdoor activity from 19 provinces (autonomous regions or municipalities) were used to analyze the current status of outdoor activity time per day for Chinese students. Results In 2016,the proportion of Chinese students who spent less than 1 hour,1~2 hours,2~4 hours and more than 4 hours for outdoor activities per day was 35.3%,39.0%,18.4% and 7.3% respectively.For the prevalence of less than 1 hour outdoor activity per day:female students (39.3%) was higher than male students (31.1%),suburban counties (36.9%) were higher than urban areas (34.2%),regular high school (48.5%)> university (39.8%)> junior high school (32.6%)> vocational high school (31.4%)> primary school (27.4%),poor social-economical region(36.6%)> medium social-economical region (35.2%)> good social-economical region (34.0%),central provinces (38.8%)> western provinces (35.2%)> eastern provinces (32.8%),the differences were all statistically significant (P<0.001).The prevalence of less than 1 hour outdoor activity per day changed with the grade significantly,peaking at third year in high school,which was closely related to academic burden.Gender differences became obvious after junior one.Hebei,Jiangxi,Henan,Anhui had the highest prevalence of less than 1 hour outdoor activity per day (more than 40%),while Beijing,Fujian,Guangdong showed the lowest prevalence (less than 30%). Conclusions In general,the daily outdoor activity time of Chinese students is low,especially among girls and regular high school students.The outdoor activities should be combined with the physical exercise,and the academic burden of students should be fully considered.

Retrospective cohort study on rapid body mass index gain in infants from birth to 1 year old

ZHAO Xiao-li, LIAO Yan, LI Li-min, XIE Chuan-bo, GU Li-ping, GAO Rui, HU Xiao-yun, GAO Jian-hui, LI Xiu-hong, WEN Xiao-zhong

2018, 26(3):  258-261.  DOI: 10.11852/zgetbjzz2018-26-03-08

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Objective To examine the predictors of rapid gain of body mass index (BMI) in infants from birth to 1 year old,and to povide the reference basis about whether there was an interaction between gestational age and birth weight percentile on rapid gain of BMI in infants. Methods A retrospective cohort study was conducted using the electronic medical record system of Maternal and Child Health Care in Zhongshan,Guangdong,China.A total of 786 infants born form January 2011 to May 2013 were errolled in this study,and completed their one-year regular child visit within 3 months before or after 12 months of age.Univariate and multivariable Logistic regression analysis were used to identify significant predictors. Results Multivariable Logistic regression analysis indicated that gestational age,birth weight percentile and maternal education were significant predictors of rapid gain of BMI in infants from birth to 1 year old.Compared with full-term infants,preterm infants were more likely (OR=19.88,95%CI:10.24~38.59) to have rapid gain of BMI in infants.Compared with appropriate for gestational age (AGA) infants,small for gestational age (SGA) infants were more likely (OR=4.59,95%CI:2.56~8.23) to have rapid gain of BMI,while large for gestational age (LGA) infants were less likely (OR=0.29,95%CI:0.12~0.69) to have rapid gain of BMI.Children whose mothers were with college degree or higher education level were less likely (OR=0.38,95%CI:0.18~0.78) to have rapid BMI gain than children whose mothers were with middle school or lower education level.There was no significant interaction between gestational age and birth weight percentile on rapid gain of BMI in infants (P>0.05). Conclusions Preterm and SGA are independent risk factors (without interaction) for rapid gain of BMI in infants from birth to 1 year of age,while high maternal education may protect against rapid BMI gain.

Efficacy evaluation of autism screening in toddlers by using the M-CHAT-R/F combined with Ages and Stages Questionnaire

LUO Mei-fang, GUO Cui-hua, CAO Mu-qing, WANG Xu-xiang, HUANG Sai-jun, JING Jin

2018, 26(3):  262-265.  DOI: 10.11852/zgetbjzz2018-26-03-09

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Objective To evaluate the efficacy of screening of autism spectrum disorders (ASDs) by using the Modified Checklist for Autism in Toddlers-Revised with Follow Up (M-CHAT-R/F) combined with the Ages and Stages Questionnaire-Third Edition(ASQ-3),in order to provide scientific basis for early identification of autism. Methods Totally 291 toddlers aged 16~30 months who have conducted routine health care in six hospitals and with positive screening Results of M-CHAT-R were enrolled in this study from August 2016 to March 2017,and the parents were invited to fill out ASQ-3 to assess the children's development of communication (C),gross motor (GM),,fine motor (FM),problem solving (SP),and personal-social (PS).Meanwhile,these children were referred to specialists for diagnostic evaluations according to DSM-5.The positive predictive value (PPV) for ASD of M-CHAT-R/F alone and that of M-CHAT-R/F combined with ASQ-3 were compared. Results A total of 53 of the 291 toddlers were diagnosed with ASD.The PPV for ASD of M-CHAT-R was 0.18.The communication domain of ASQ-3 had the highest suspicious developmental delay rate in both M-CHAT-R screening positive group and ASD group,followed by PS domain.The PPV for ASD detection could be increased to 0.43 using communication and PS domains as predictors on the basis of M-CHAT-R.Without follow-up interview,ASQ-3 could greatly improve the PPV of M-CHAT-R (0.43 vs.0.18,P<0.001). Conclusions M-CHAT-R combined with ASQ-3 could improve the screening effcacy of toddlerhood ASD.It is recommended to conduct assessment by ASQ-3 for toddlers with positive screening Results of M-CHAT-R.

Epidemiological investigation of children with autism spectrum disorders from 0 to 6 years old in Hainan province

LI Ling, LI Xiao-ling, WU Wei-xue, CAI Xiao-fan, FAN Xia-lin, WEI Xiu-hui, SUN Ting-ting, JIAO Yun, XIANG Wei

2018, 26(3):  266-268.  DOI: 10.11852/zgetbjzz2018-26-03-10

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Objective To describe the prevalence,distribution and difference of children with autism spectrum disorders (ASD) at the age of 0 to 6 years old in Hainan province. Methods Totally 37 862 children aged 0～6 years were selected from 18 different cities and counties in Hainan province,and were screened by the "Child Development Issues Warning Signs" questionnaire,diagnosed by clinical specialists. Results A total of 235 children were diagnosed with autism spectrum disorders from 37 862 children aged 0 to 6 years,and the ASD prevalence was 0.62%.The difference on ASD prevalence between boys (0.99%) and girls (0.17%) were statistically significant (χ²=101.91,P<0.001).The older children had higher prevalence of ASD with signficant difference (χ²=288.62,P<0.01).Also,the autism rate in urban areas was significantly higher than that in other regions (χ²=114.77,P<0.001). Conclusions The prevalence of ASD in children aged 0~6 in Hainan province is high in the domestic and children are diagnosed with ASD at their older age.So it is urgently needed to improve the early diagnosis rate.

Research progress in risk factors and prevention of congenital heart disease

HUANG Ji-wei, TANG Ning

2018, 26(3):  269-272.  DOI: 10.11852/zgetbjzz2018-26-03-11

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Recently,the incidence of congenital heart disease is increasing year by which leapts to the top of Chinese birth defects.It has been a major public health problem that affecting physical and mental health of infants and the quality of life of the population,bringing serious mental and economic burdens to the family and society.Therefore,studing of etiology and risk factors of congenital heart disease will promote defect screening and prevention,as well as reduce the incidence of congenital heart disease,which is of strategic significance to improve the quality of the population.

Research progress on vitamin A,E and recurrent respiratory tract Infection

DONG Li-juan, YANG Shu-fen

2018, 26(3):  273-275.  DOI: 10.11852/zgetbjzz2018-26-03-12

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Repeated respiratory tract infection is one of the common respiratory diseases in children.The latest research shows that vitamin A and E are closely related to recurrent respiratory tract infection,the changes of serum vitamin A and E levels in children with recurrent respiratory tract infection can effect immune function.Timely inspection of vitamin A and E levels of children and treatment can reduce the incidence of recurrent respiratory tract infection of children,but there is no definite conclusion.This paper reviews the development of the relationship between recurrent respiratory tract infections and vitamin A,E synergy adjuvant therapy,in order to provides the theory basis for recurrent respiratory tract infections.

Research progress on the relationship between the level of vitamin D during pregnancy and the adverse health consequences of the newborns

CHEN Xiao-li, YANG Shu-fen

2018, 26(3):  276-278.  DOI: 10.11852/zgetbjzz2018-26-03-13

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Vitamin D (Vit D) is a kind of steroid derivatives that play important an important role in humanbeings.Vitamin D deficiency can lead to a variety of diseases.In recent years,vitamin D deficiency is found to be serious during pregnancy.The impacts of vitamin D deficiency during pregnancy on the neonatal adverse outcomes are reviewed in this article in order to improve the understanding of vitamin D supplements during pregnancy and to reduce the incidence of neonatal adverse outcomes.

Influence of meconium-stained amniotic fluid on the neonatus

LIU Chun-yu, ZHANG Xiao-jia, JIN Zhen-ai

2018, 26(3):  279-281.  DOI: 10.11852/zgetbjzz2018-26-03-14

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Meconium-stained amniotic fluid (MSAF) is mainly seen in full-term and expired pregnancy.It has been widely accepted that meconium flowing into the amniotic fluid can be either the mature sign of the fetus or the sign of fetal distress.The declining cleaning ability of the placenta to reduce meconium has become a new statement during the past years,which has also been paid much attention as one of its main pathogenesis for meconium-stained amniotic fluid.MSAF can damage multiple systems of the fetus.Also,MSAF can be diagnosed in time through direct observation,ultrasound and other methods,and timely intervention in fetus and newborns should also be carried out in order to reduce the adverse effects on perinatal infants and improve quality of life.

Effective domains and intervention routes of pivotal response treatment for autism spectrum disorder

DU Xiang-yang, ZHAO Hui, XIAO Hui, LI Mei

2018, 26(3):  282-285.  DOI: 10.11852/zgetbjzz2018-26-03-15

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As a rising natural intervention model,pivotal response treatment (PRT) is widely proved its effectiveness.The effective domains and intervention routes are discussed by the related references.It is found that PRT is effective in the four critical domains except the domain of empathy and other domains such as language training,joint attention,academic performance,social interaction and disruptive behaviors.Parents education,school education,peer training,community activity,and individual instruction are all proved be the effective routes of PRT.

Meta-analysis on association of vitamin D intake in pregnancy with infants asthma

CHEN Hui, LIN Xiao-xia, CHEN Yan-hui

2018, 26(3):  286-289.  DOI: 10.11852/zgetbjzz2018-26-03-16

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Objective To evaluate the association of vitamin D intake in pregnancy with infants asthma. Method VIP,Wanfang,CNKI,PubMed,and OVID databases were searched,in order to collect studies regarding association of vitamin D intake in pregnancy with infants asthma to conduct Meta-analysis. Results Totally 5 prospective cohort studies and 4 RCTs were included in this study.1)All 5 articles had reported that higher maternal intake of vitamin D during pregnancy may significantly decrease the risk of asthma or wheeze in early childhood.2)Two of the fore RCTs were conducted Meta-analysis finally.A total of 1 355 mother-children pairs were enrolled,including 683 pairs in group with vitamin D supplementation and 672 pairs in group with placebo.The Results showed that prenatal vitamin D supplementation was reduced the risk of infants asthma compared to the placebo (OR=0.71;95%CI:0.54～0.92;P=0.01). Conclusion Higher prenatal intake of vitamin D may decrease the risk of infants asthma.

Study on breastfeeding difficulties and related influencing factors among infants aged 0~5 months

YE Fang, LIN Hong, CHEN Jie, LIU Fang, FAN Qin-ying, ZHANG Yong, WANG Lin

2018, 26(3):  290-293.  DOI: 10.11852/zgetbjzz2018-26-03-17

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Objective To investigate the present situation of breastfeeding difficulties and its influencing factors in an urban area in Beijing,so as to provide scientific evidence for formulating interventions. Methods A cross-sectional survey was conducted to collect data of 120 cases of infants aged 0 to 5 months fed by breast milk and their mothers from Jan.1^st to Dec.31^th,2016.Participants were investigated with general information questionnaire and Via Christi breastfeeding assessment tool. Results The mean score of Via Christi tool was 8.2±1.4.Seventy percent of infants were assessed as low risk while the rest as medium risk.The items of "length of time before latch-on and suckle" and "latch-on" received lowest scores with 1.0±0.9 and 1.7±0.4.Exclusive breastfeeding during the first week after birth [OR=0.140,95%CI:(0.024~0.802)] and vaginal birth [OR=0.343,95%CI:(0.174~0.879)] were two protective factors of breastfeeding(P<0.05).Floating population [OR=8.679,95%CI:(1.558~48.338)] and preterm [OR=5.470,95%CI:(1.216~25.030)] were two hazardous factors(P<0.05). Conclusions The most problematic procedures during breastfeeding were "latch-on" and "length of time before latch-on and suckle".Priority attention should be given to infants with hazardous factors including floating population,mixed feeding during the first week after birth,preterm,and C-section.

Impact of a multidisciplinary team systematic management on the neurodevelopmental outcomes of neonatal intensive care unit preterm infants

TIAN Yuan, ZHANG Yu-ming, CHEN Fei, FENG Jin-cai, ZHANG Chun-cao, HU Xiang-ying, YU Guang-jun

2018, 26(3):  294-297.  DOI: 10.11852/zgetbjzz2018-26-03-18

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Objective To analyze the impact of systematically follow-up and early intervention on the recent neurodevelopmental outcomes of neonatal intensive care unit (NICU) preterm infants in a multidisciplinary team (MDT) framework. Methods Retrospective analysis and intervention-controlled study were conducted.The developmental abnormalities ratio of the recorded preterm infants discharged from Shanghai Children's Hospital were analyzed and the outcomes were compared with those under systematically follow-up and early intervention The impact of MDT systematically follow-up and early intervention on the neurodevelopmental outcomes of NICU preterm infants were evaluated through a prospective intervention-controlled study. Results Totally 997 infants discharged from NICU were recorded and analyzed from Jan. 1999 to Jun.2016 Infants with systematically follow-up and early intervention had lower developmental abnormalities ratio (P<0.05).Intervention-controlled study further showed that infants in intervention group could be developed to the average scores. Conclusion Preterm infants discharged from NICU need systematically follow-up and effectively early intervention by specialist in a MDT framework to make sure a better outcome.

Analysis of two families with rare thalassemia and prenatal diagnosis

ZHU Xiao-jie, LIU Lu, LIU Rui-yu, LI Xu-yan, ZENG Hong, CAO Bi-hong, WANG Chun-hui, ZENG Wen-bing

2018, 26(3):  298-300.  DOI: 10.11852/zgetbjzz2018-26-03-19

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Objective To analyze 2 families with rare thalassemia and make prenatal diagnosis thalassemia. Methods The family members' peripheral blood samples were analyzed by whole blood cell analysis and hemoglobin analysis with capillary zone electrophoresis.Conventional α and β thalassemia genes were detected by flow-through hybridization for peripheral blood samples and amniotic fluid samples.Multi-Link Probe Amplification Technology(MLPA),DNA sequencing,gap PCR (Gap-PCR) and continuous electrophoresis of hemoglobin were used to analyze the rare genotypes. Results A case of rare type of β-thalassemia with Vietnamese deletion and a case of sea deletion compound of α2 gene CD124 mutation were detected in 2 families.To prenatal diagnosis among 2 families,one of the fetuses was detected for β-thalassemia with Vietnamese deletion,another was α thalassemia with sea deletion. Conclusions When the Results of hematological phenotype and genotype do not match,much attention should be paid to further detection of rare genotypes to avoid missed diagnosis or misdiagnosis,especially to the couples who have had children with severe thalassemia.The finding may enrich knowledge of the screening in thalassemia as well as the genetic counseling and clinical diagnosis.

Incidence and risk Factor of iron deficiency anemia of infants at the age of 6~8 months in Beijing

ZHAO Yong-xian, JIA Zhao-xia, HUANG Li-li, WANG Zhao, WU Ming-hui

2018, 26(3):  301-304.  DOI: 10.11852/zgetbjzz2018-26-03-20

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Objective To understand the incidence and risk factors of iron deficiency anemia of 6~8-month-old infants in Beijing,in order to provide data support for further development interventions of infant anemia. Methods A cohort study was conducted,and stratified cluster sampling was used to select newborns having their health care in the community healthcare centers,and then following up the infants till the first blood test.After data cleaning,the single factor and Logistic regression were used to explore the risk factors of iron deficiency anemia. Results A total of 2 243 children were involved in this study,and the incidence of iron deficiency anemia was 19.6%(446/2 243).Logistic regression showed that infants at the age of 6 to 8 months old whose parents' owning agricultural registered permanent residence(OR=1.568,95%CI:1.164~2.112),whose family had more than one child (OR=1.490,95%CI:1.150~1.929),whose father was younger than 25 years old when the child was born (OR=1.660,95%CI:1.119~2.464),whose mother did not use chalybeate before pregnancy (OR=1.440,95%CI:1.071~1.936),who was delivered in the second level hospital (OR=1.465,95%CI:1.112~1.931),who are low birth weight (OR=3.340,95%CI:1.398~7.980),who was a boy (OR=1.285,95%CI:1.025~1.611) and who was breastfed (OR=2.217,95%CI:1.584~3.102) have a higher risk to anemia. Conclusion 1)The incidence of iron deficiency anemia in 6 to 8-month-old infant is high in Beijing.2)The factors influencing the infant iron status and socio-economic factors can lead iron deficiency anemia in infants.

Aggregation analysis of birth defects in rural area of Pingyin County,Shandong Province

ZHANG Long-fei, YIN Yan-fang, WU Yan-ling, ZHANG Shu-xia, WANG Zhi-ping

2018, 26(3):  305-307.  DOI: 10.11852/zgetbjzz2018-26-03-21

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Objective To analyze the clustering characteristics of birth defects in rural areas of Pingyin County,Shandong province from 2004 to 2016. Method The numbers of birth defects in each village were calculated,and were fitted by Poisson distribution and negative binomial distribution. Result The distribution of birth defects did not fit the Poisson distribution (χ²=30.33,P<0.001),but fit the negative binomial distribution (χ²=4.56,P=0.336). Conclusion The distribution of birth defects cases at village level presented spatial clustering in rural areas of Pingyin county through 2004-2016.

Effect of chiropractic therapy on feeding intolerance in very preterm infants

DING Ying-xue, REN Yan-fang, CUI Hong

2018, 26(3):  308-310.  DOI: 10.11852/zgetbjzz2018-26-03-22

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Objective To analyze the effects of chiropractic therapy on feeding intolerance in very preterm infants. Methods Very preterm infants with gestation age less than 32 weeks with feeding intolerance form intensive care unit of pediatrics department in Beijing Friendship Hospital were randomly divided into two groups from Jan.1st,2016 to Mar.31th 2017:chiropractic therapy group and regular therapy group.Each group was 20 preterm infants and all with early minimal enteral feeding.There was no significance in gestation age,birth weight and sex among two group. Results Compared with regular treatment,duration of feeding intolerance,average day of reaching enteral feeding and average day in hospoital became shorten after chiropractic therapy,and the difference was significant (P<0.05).There was no significant difference for treatment effectiveness (P=0.051)although clinical symptoms improved,such as vomiting and abdominal distension,milk volume,improved after chiropractic therapy. Conclusions Chiropractic therapy is safe for very preterm infants with feeding intolerance.Chiropractic therapy can rapidly relief clinical symptoms and promote growth and development.

Investigation and analysis of overweight and obesity base on Wechat platfrom among children aged 0~5 years in the Eastern China

SHEN Li, TIAN Yuan, YU Guang-jun

2018, 26(3):  311-313.  DOI: 10.11852/zgetbjzz2018-26-03-23

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Objective To understand the prevalence of overweight and obesity among children in the eastern China,and to explore the advantages and disadvantages of data collection based on WeChat in order to give support for the future investigation and effective intervention. Methods Parents of children aged 0~5 years filled the data on the WeChat platform.A total of 19 793 children in eastern China were selected in this study,including 11 770 boys and 8 023 girls.Weight for height obese criteria recommended by WHO in 2007 was used as the diagnostic indexes of overweight and obesity.The incidence rates of overweight and obesity among children were compared with the data in nine cities of China in 2006. Results The incidence rates of overweight and obesity among children aged 0~5 years in eastern China were respectively 10.1% and 4.2%.The incidence rates of obesity among boys were higher than those among girls(χ²=14.965,P＜0.001).In 0~1-year-old group and 2~3-year-old group,the incidence rates of obesity among boys were higher than those among girls(χ²=9.528 and 14.066,all P＜0.001).The incidence rates of overweight and obesity among children in eastern China were higher than that in nine cities of China in 2006(P＜0.01). Conclusion The incidence rates of overweight and obesity among children aged 0~5 years in eastern China are high,and the utilization of mobile platforms for research is faster and more convenient.

Research on T lymphocyte and clinical efficacy of different doses of vitamin D₃ in children with asthma

WANG Yu-fang, ZHANG Jing-li, SHI De-rong, WANG Xiao-bo, HUANG Guang-ju

2018, 26(3):  314-317.  DOI: 10.11852/zgetbjzz2018-26-03-24

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Objective To investigate the effect of different doses of vitamin D₃ on T lymphocyte subsets in children with bronchial asthma and on the improvement of asthma control levels,and to explore the mechanism and optimal dose of vitamin D₃ in the treatment of bronchial asthma in children. Methods A total of 120 children with bronchial asthma aged from 6 to 13 years were selected.In addition,30 healthy children were selected as the normal control group in the same period.The selected patients were randomly divided into 4 groups,including one group of conventional treatment and three groups of vitamin D₃ treatment on the basis of conventional treatment.The doses of vitamin D₃ were 400 U,600 U and 800 U per day,respectively,and the total course of treatment was 12 months.The T lymphocyte subsets were detected before treatment,1 month,3 months,6 months and 12 months after treatment.The control level of asthmatic children was counted at 12 months after treatment. Results After 12 months,the levels of CD4,CD4/CD8 in blood were significantly lower than those before treatment,and CD8 was significantly elevated,but compared with the control group,there were still significant differences.After 6 months of treatment,in the 600 U and 800 U treatment groups,the levels of CD4 and CD4/CD8 were decreased more significantly than the other two groups.The asthma control level of the 600 U and 800 U treatment group was significantly higher than that of the other two groups after treatment,but there was no significant difference between the 600 U and 800 U groups (P>0.05). Conclusions Oral intake of different doses of vitamin D₃ can regulate the imbalance of T lymphocyte subsets,which is one of the mechanisms of vitamin D₃ in the treatment of asthma,but it still requires a long process.Vitamin D₃ treatment significantly improved the control level of asthma,daily intake of 600 U may be the best treatment dosage.

Analysis of physical development in preschool children in Aba Tibetan and Qiang Autonomous Prefecture in 2015

ZUO Qing-hua, LIAN Xiao-xia, HE Jiang-long, CAI Yuan-xing, YAN Yan, RAN Yu-chen

2018, 26(3):  318-321.  DOI: 10.11852/zgetbjzz2018-26-03-25

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Objective To investigate the growth status of preschool children in Aba Prefecture,and to provide evidence for improving nutritional status of children in minority areas. Methods A total of 4 368 children from the kindergartens of eight counties in Aba Prefecture were enrolled in this study by using stratified and cluster random sampling method in 2015.And the height,weight,head circumference and chest circumference were measured.Results were evaluated according to reference standard for WHO (2006) by Z scores. Results Boys' weight,head circumference,chest circumference and body mass index(BMI) in most age groups were significantly higher than those of girls(P<0.05).The values of height,head circumference,chest circumference and BMI were significantly different in the nations.Children's HAZ (Z-scores of length/height-for-age),and WAZ(Z-scores of weight-for-age )were negative values in Aba Prefecture.The difference of HAZ and WAZ were statistically significant between the urban and rural areas in different nations(P<0.05). Conclusions The physical development status of preschool children in Aba Prefecture still lag behind the WHO standard.Attention should be paid to the health care of the preschool children in the kindergartens.

Analysis of related factors for multiple drug resistant bacteria infection in children with severe bacterial pneumonia

XIE Zhao-yun, XIONG Yun, QIN Jia-lu, YANG Zhong-ling, HU Yang

2018, 26(3):  325-328.  DOI: 10.11852/zgetbjzz2018-26-03-27

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Objective To analyze the related factors of multiple drug resistant bacteria infection in children with severe bacterial pneumonia. Methods A retrospective analysis was conducted from January 2011 to November 2015 to collect clinical data of 457 cases of children with bacterial severe pneumonia including 96 cases of multi drug resistant bacteria infection patients and 361 cases of non multi drug resistant bacteria infection of difference.Related factors analyzed by multivariate Logistic regression analysis. Results A total of 96 patients were with multi drug resistant strains of bacteria,including 68 males,28 females,aged 0~14 years old,and the average age was(6.09±4.51) years old.And 361 patients were without multi-drug resistant strains of bacteria,including 228 males,133 females,the average age was (5.34±4.63) years old.Multifactors analysis showed that the previous use of antimicrobial agents[OR=1.093,95%CI(1.014~1.179)],in PICU days [OR=3.613,95%CI(1.874~6.969)],and traumatic treatment after infection [OR=2.296,95%CI(1.141~4.619)],combined application of antibiotics [OR=6.861,95%CI(3.510~13.409)],antibiotic use days after infection [OR=1.295,95%CI(1.125~1.409)] were the main factors of multi drug resistant bacteria infection in children with severe bacterial pneumonia (P<0.05). Conclusion Effective measures should be taken to prevent and reduce the multiple drug resistant bacteria infection in children with bacterial pneumonia.

Investigation of screening methods of developmental dysplasia of the hip in newborn infants

LI Guan-ming, FANG Xiao-yi

2018, 26(3):  329-331.  DOI: 10.11852/zgetbjzz2018-26-03-28

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Objective To analyze the most appropriate method for the diagnosis of developmental dysplasia of the hip (DDH),thereby making it possible to treat DDH earlier and achieve good prognoses by assessing the role of clinical examinations,ultrasonic (US) examination and associated risk factors in infants with DDH. Method Totally 139 infants hospitalized in the NICU of the first affiliated hospital of Shantou University Medical College from November 2014 to November 2015 were involved.Clinical data and Results of physical examinations and US examinations of the hips were collected,and followed up according to the results.Several risk factors which may affect hip development were analyzed. Results 1)Among 139 infants,83 (59.7%) had abnormal US examinations,in which 6 were Graf type Ⅱc and one (0.7%) was eventually diagnosed as hip dislocation.2)The study showed higher prevalence of DDH in left side hip than the right ride (OR=1.863,P<0.05) and in breech presentation (OR=4.063,P<0.05).3)Compared with US results,clinical examination had a sensitivity of 42.1% and specificity of 66.1%.4) Gender,gestational age,delivery mode,amniotic fluid volume and PE Results did not have significant difference in DDH prevalence. Conclusions To detect DDH,US examination is necessary and important since the sensitivity and specificity of clinical examinations are quite low.The left side hip and breech presentation are significantly associated with DDH.Most Graf type Ⅱa hips and some Graf type Ⅱc hips resolve spontaneously at the age of 3~6 months,but close follow-up is recommended.

Clinical observation of the effect of serum vitamin D levels on the neural development in 18 months old infants

XIONG Shu-ying, HUANG Xu-li

2018, 26(3):  332-334.  DOI: 10.11852/zgetbjzz2018-26-03-29

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Objective To explore the effect of serum vitamin D levels on the neural development in 18 months old infants,and to provide theory basis for prevention and intervention. Methods Serum vitamin D levels of 1 283 infants aged 18 months were detected and divided into three groups (deficiency,insufficiency,and normal group)from June 2014 to May 2017.They were assessed with Developmental Screen Test (DST),an intellectual developmental screening test developed by Pediatric Hospital of Fudan University in Shanghai,and the differences of developmental quotient,exercise capacity,social adaptation,intelligence of three groups were compared. Results 1)The detection rates of vitamin D deficiency,insufficiency,and normal range were 3.35%,30.16% and 66.48% respectively.The difference on serum vitamin D was not significant in three groups (t=3.507,P>0.05).2)The values of the intelligence in the deficiency group were significantly lower than those of normal group (t=5.657,P<0.05). Conclusion Vitamin D dificiency has a negative effect on neuropsychological development,and Vitamin D should be promptly added to infants of vitamin D deficiency.

Analysis of nutrition and growth of kindergartens children in Fengjie County in 2016

XIANG Yang

2018, 26(3):  335-337.  DOI: 10.11852/zgetbjzz2018-26-03-30

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Objective To analyse the relationship between dietary nutrition and growth index of children in Fengjie County,and to find the disadvantages of dietary management of kindergartens,in order to improve the dietary management guidance. Methods The dietary nutrition was detected by the weighing method of nine kindergartens in second quarte in 2016.And the height and weight,blood biochemical index of children were also tested to analyze the dietary and nutritional status. Results The dietary energy could basically meet the requirements of the children,but there were still some problems such as inadequate intake of nutrients or irrational dietary structure.Dietary intake of proteins,fats,carbohydrates and sodium were higher,sodium and phosphorus intake exceeded,while calcium was inadequate. Conclusions The diet in kindergartens in Yong'an town of Fengjie county is not reasonable.Further improvement of the dietary structure is needed to enhance the normal growth and development of children.

Disease analysis of 7 531 newborn hospitalized in a hospital in Weinan

LIU Yue-wen, CAO Fang-qin

2018, 26(3):  338-340.  DOI: 10.11852/zgetbjzz2018-26-03-31

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Objective To analyze the distribution and change trend of neonatal diseases,and to grasp the neonatal disease constitution rule. Method Neonatal cases admitted from 2013 to 2015 in Maternal and Child Health Care Hospital of Weinan were analyzed. Results A total of 7 531 cases were enrolled,and the top three of the diseases in turn were neonatal pneumonia,neonatal bilirubin hematic disease,neonatal sepsis.The prevelance rates of neonates who were cesarean deliveried and sick from 2013 and 2015 showed a downward trend (χ²=28.000,45.128,P<0.05),but the rates of the early premature and low birth weight were increased (χ²=15.011,25.805,P<0.05),The prevelance of neonatal pneumonia,neonatal high blood bilirubin,meconium inhaled syndrome had lower trend (χ²=15.011,15.011,15.011,P<0.05);neonatal respiratory distress syndrome (NRDS) had increased (χ²=16.902,P<0.05). Conclusions Pneumonia,high bilirubin hematic disease,sepsis arel major diseases in neonates,and the increasing prevecance of NRDS needs to pay more attention to.It is crucial to strengthen the health education in the perinatal period,to give timely diagonosis and timely treatment,to improve the technical level of professionals in order to reduce neonatal diseases.

Analysis of early clinical features of six children with spinal muscular atrophy type Ⅰ

WAN Rui-ping, WU Yan-ling, LI Xiao-li, LI An-fang, LIU Zhi-gang

2018, 26(3):  341-343.  DOI: 10.11852/zgetbjzz2018-26-03-32

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Objective To analyze the early clinical features of spinal muscular atrophy type Ⅰ (SMA-Ⅰ). Method Early clinical features and relative assistant examinations of six children with SMA-Ⅰ diagnosed in Foshan Maternal and Child Health Care Hospital from Oct.2015 to Oct.2016 were retrospectively analyzed. Results Gene detection of six children showed homozygous deletion of exon 7,8 of the SMN1 gene,with only 2 copies of SMN2 gene.All children presented with profound weakness of the trunk and limbs,poor head control,lack of active movement,severe hypotonia,absent tendon reflexes,and low crying voice.However,swallowing weakness and feeding intolerance were not obvious before 2 to 3- moth -old infants.Some children were born with joint contracture.Neonatal behavioral neurological assessment (NBNA) was carried out to four of six children.And the total score of NBNA was significantly lower than that of normal level. Conclusions Profound weakness of the trunk and limbs,low crying voice are typical clinical features of SMA-Ⅰ children at the early stage.SMN gene detection should be applied to children with very low NBNA total scores.

Study on the development of scientific parenting index system of 0~3 -year-old infants' parents

DAI Zhi-hui, LIU Ai-zhong, HE Hua-xian

2018, 26(3):  344-346.  DOI: 10.11852/zgetbjzz2018-26-03-33

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Objective To develop an assessment indicator system of scientific parenting in order to understand of 0 ~3 years old infants' parenting levels,to analyze the influencing factors of infants' health,and to provide theoretical basis for perfecting mechanism of maternal and child health. Methods Literature research,expert consultation and group discussion were used to build a scientific assessment indicator system.And a questionnaire survey was conducted by the Delphi method to rate the preliminary index system. Results After three rounds of experts consultation,the assessment indicator system of scientific parenting was built,including 3 first indexes,13 secondary indexes,75 tertiary indexes;Expert grading method was used to decide the weight of each level,which in the first-level indicators,infant care accounting for 42%;Infant development accounting for 35%; Family adapt accounting for 23%.A total of 16 experts completed three-round Delphi method,and the average work year was 26.18±7.76;Among them were senior title 13 people,accounting for 81.25%;the expert authority coefficient was 0.90;The coordination coefficients of the three rounds of consultation were 0.290,0.308 and 0.378 respectively. Conclusions A set of systematic comprehensive evaluation index system of scientific parenting is established in this study.It is important and far-reaching significant for the self-assessment of parents parenting and for the healthy development of infants and young children.