Table of Content

10 June 2018, Volume 26 Issue 6

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Diagnosis and treatment of micropenis in boys

XIAO Yan-feng, YIN Chun-yan

2018, 26(6):  581-583.  DOI: 10.11852/zgetbjzz2018-26-06-01

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Micropenis is a kind of medical diagnosis based on correct measurement of length. If stretched penile length is below the value corresponding to -2.5 standard deviation of the mean in a patient with normal internal and external male genitalia, a diagnosis of micropenis is considered. The current lack of reference values for the length of the penis has made clinical diagnosis more difficult. Micropenis can be caused by a variety of factors including structural or hormonal defects of the hypothalamic-pituitary-gonadal axis. It can also be a component of a number of congenital syndromes. For the etiological evaluation, endocrinologic tests are important. This article reviews the etiology, diagnosis, treatment and management of micropenis.

Update of diagnosis and treatment for male hypogonadism in children

LI Tang, HU Si-cui

2018, 26(6):  584-586.  DOI: 10.11852/zgetbjzz2018-26-06-02

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Male hypogonadism in children is common in pediatric endocrineclinic,characterized by delayed puberty, gonadal dysgenesis and the hypofunction of hypothalamic-pituitary-gonadal axis. The causes of hypogonadism can be divided into 2 categories: primary hypogonadism and secondary hypogonadism(hypogonadotropic). Male hypogonadism in children and adolescents is common clinically, while hypogonadism in newborns and infants is often ignored. There still have been many disputes in the diagnosis and treatment of childhood hypogonadism. In this paper, the problem will be discussed in order to proride reference for pediatricians.

Effects of polyethylene glycol recombinant growth hormone on serum p53 and p21waf / cip1 expression in children with idiopathic short stature

PENG Yan, ZHANG Chong-jian, WANG Ying, HE Zhi-hong

2018, 26(6):  587-589.  DOI: 10.11852/zgetbjzz2018-26-06-03

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Objective To observe the treatment efficacy of polyethylene glycol recombinant growth hormone on idiopathic short stature children and its effect on the expression of p53 and p21waf/cip1. Methods A total of 121 children with idiopathic short stature treated in Ya′an Maternal and Child Health Care Planning Service Center from February 2015 to October 2016 were selected in this study and divided into control group (n=61) and treatment group (n=60) according to random number table method.The control group was treated with nutrition therapy, while the treatment group was treated with polyethylene glycol recombinant growth hormone in addition to nutritional therapy.The clinical efficacy and the adverse reactions incidence were observed, and the differences on IGF-1/IGFBP-3 as well as the expression of p53 and p21waf/cip1 before treatment, 3 months, 6 months after treatment were compared. Results The height of the treatment group was significantly higher than that of the control group after the treatment (P<0.05).The levels of IGF-1 and IGFBP-3 were increased with treatment time prolonged.The levels of IGF-1 and IGFBP-3 in the treatment group were significantly higher than those of the control group at the same point (P<0.05).There was no significant difference on the serum p53 mRNA levels between treatment group and control after treatment (P>0.05), while the expression level of p21waf/cip1 mRNA in the treatment group decreased with treatment time prolonged and it was significantly lower than that in the control group (P<0.05). Conclusions Polyethylene glycol recombinant human growth hormone has a significant therapeutic effect on idiopathic short stature children.And it is of great value in clinical application because of its efficacy in increasing the height of patients and improves cell proliferation.

Investigation on the self-concept of children with precocious puberty

AI Li-li, JIA Shou-mei, ZHANG Yu-xia, LUO Fei-hong, WANG Shuang-yu, GU Ying

2018, 26(6):  590-593.  DOI: 10.11852/zgetbjzz2018-26-06-04

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Objective To investigate the self-concept of children with precocious puberty. Methods Piers-Harris Children′s Self-Concept Scale (PHCSS) and general questionnaire were used to investigate the self-concept of children with precocious puberty in Pediatric Hospital Affiliated to Fudan University from Nov 2016 to Sep 2017. Results The rate of low self-concept among children with precocious puberty was 27.8%.And the scores of body image and anxiety dimension in children were significantly lower than national norm.Children whose mother had low education level, with inconsistent parental education, and who were not the only children in family had lower self-concept. Conclusions The self-concept level of children with precocious puberty is low, so more attention should be paid to these children.Also, targeted intervention measures should be developed in order to improve the level of the precocious children′s self-concept, and to promote the precocious children′s physical and mental health.

Analysis of psychological status of school-age children with short stature and their parents

XIONG Fei, HUANG Li-li, YANG Fan

2018, 26(6):  594-596.  DOI: 10.11852/zgetbjzz2018-26-06-05

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Objective To investigate the psychological status of school-age children with short stature and their parents, in order to provide reference for further intervention. Methods The psychological status of 50 school-age children with short stature and normal children was assessed by scales including Piers-Harris Children′s Self-concept Scale, Eysenck Personality Questionnaire, Spence Children′s Anxiety Scale and Pediatric Quality of Life Inventory from January to June 2017.The psychological status of their parents was investigated with self-rating anxiety scale (SAS) simultaneously. Results The scores of behavior, intelligence and school performance, body appearance and affiliation subscales in school-age children with short stature was significantly lower than those in normal school-age children (P<0.05).The results of SAS indicated that the score of body panic disorder in children with short stature was higher than that in control group, while the scores of fear for physical injury and obsessive compulsive disorder in normal control group were higher than those in children with short stature (all P＜0.05).Compared with normal children, children with short stature tended to be introverted.There was no significant difference on SAS scores between parents of children with short stature and normal children (P＞0.05). Conclusion Psychological disorder is still prevalent in children with short stature,soearly psychological support should be given to them in addition to drug treatment.

Phonological characteristics and rehabilitation training efficacy of abnormal lingua-palatal phoneme in children with functional articulation disorders

MIN Zhi-yun, LI Feng, XU Li-na, HU Ming-fang

2018, 26(6):  597-601.  DOI: 10.11852/zgetbjzz2018-26-06-06

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Objective To explore the phonological characteristics and rehabilitation training efficacy of abnormal lingua-palatal phoneme in patients with functional articulation disorders (FAD). Methods Totally 120 children with FAD were enrolled from February 2016 to February 2017 and received rehabilitation training. The training efficacy and the correlation between abnormal lingua-palatal phoneme articulation and age were analyzed. Results The articulation disorder of /j/ mainly showed being replaced by /x/,/d/, lateral misarticulation or omission;/q/ mainly showed replacement by/j/,/x/,/t/ or lateral misarticulation; /x/ mainly showed replacement by/j/ or lateral misarticulation. The common erroneous articulation forms of /j/,/q/, /x/ were replacement and lateral misarticulation.Finally, 104 cases were cured and 13 cases improved after 3~6 weeks of rehabilitation, and the overall cure rate was 86.67% (104/120). The cure rates of mild, moderate and severe disorder were 100% (7/7), 82.61% (19/23) and 86.67 % (78/90) respectively. The number of erroneous wordssignificantly decreased from 23.11±9.41 to 1.85±6.17 after training(Z＝-13.012,P＜0.001). The number of erroneous words was not correlated with age (r＝-0.045,P=0.626). Conclusions The articulation disorder of lingua-palatal phoneme is mainly replacement and lateral misarticulation. And specific speech rehabilitation training is effective for FAD.

Sleep arrangement and effect on sleep outcomes among Chinese infants

YANG Fang, LIN Qing-min, WANG Guang-hai, JIANG Fan

2018, 26(6):  602-605.  DOI: 10.11852/zgetbjzz2018-26-06-07

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Objective To investigate sleep arrangement,influencing factors,and effects on sleep outcomes among Chinese infants. Methods According to the Hospital of Province-Cite-County sampling technical route from 2012 to 2013,a total of 1 304 healthy full-term children at the age of 0~35 months were sampled by stratified cluster random sampling method from 8 provinces in China. Parents filled out the Brief Infant Sleep Questionnaire (BISQ) and a self-designed Children′s Personal and Family Socio-demographic Environment Questionnaire to assess sleep arrangements,sleep patterns and socio-demographic factors. Results The average age of infants was (12±10) months,with boys accounting for 53.8%.The percentage of bed-sharing was 84.8％,the room-sharing was 13.2%,and the solitary sleep was 2.0%. Compared with infants under 6 months old,the proportion of bed-sharing for infants aged 6 months or older was significantly higher,room-sharing was significantly lower(all P<0.05),and no significant difference in solitary sleep existed(P>0.05). Multivariable Logistic regression analysis showed the risk factors of bed-sharing were infants aged 6 months or older,family per capita monthly income ≤3 000 yuan and residential suburb. General linear regression analysis showed the predictive effects of bed-sharing on any sleep parameters were not statistically significant(all P＞0.05). Conclusions Bed-sharing is common in Chinese infants aged 0~35 months,with much higher incidence rate than western compartments. Although bed-sharing is associated with infants′age and socioeconomic status,it is not recognized to have direct effects on sleep outcomes.

Analysis of cut-off value in screening of moderate and severe β-thalassemia by    capillary hemoglobin electrophoresis for neonates

YANG Jin-ling, CAI Ren, TAN Jian-qiang, CHEN Da-yu, HUANG Li-hua, WEI Jiang-yan, LAN Hai-you

2018, 26(6):  606-610.  DOI: 10.11852/zgetbjzz2018-26-06-08

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Objective To analyze the characteristics of capillary hemoglobin electrophoresis in neonates,and to determine the cut-off values of hemoglobin for moderate and severe β-thalassemia screening in neonates. Methods Retrospective analysis was performed on the results of capillary hemoglobin electrophoresis and genetic testing for 1 020 neonates. Neonates were assigned to 6 groups according to the gestational age at birth and the genetic testing results,and the HbA and HbF levels in each group were analyzed. The cut-off values for screening for moderate and severe β-thalassemia in neonates were determined using receiver operating characteristics (ROC) curve. Results HbA level was lower in moderate and severe β-thalassemia group than that in any other groups except the abnormal hemoglobin group (P<0.05); HbF level was higher in moderate and severe β-thalassemia group than that in any other groups(P<0.001). The area under curve (AUC) for HbA screening for moderate and severe β-thalassemia in neonates was 0.993,which was greater than 0.697 of HbF screening. The sensitivity and specificity of HbA cut-off values (2.35%) were 100% and 99.0%,respectively. Conclusions The cut-off value of HbA for capillary hemoglobin electrophoresis screening for moderate and severe β-thalassemia in neonates is 2.35%; Based on the cut-off value of HbA for capillary hemoglobin electrophoresis,HbF level and hemoglobin electrophoretograms could further reduce false positives.

Survey on common gastrointestinal problems among infants aged 1~12 months in fifteen cities in China

WANG Shuo, WANG Hui-shan, SHENG Xiao-yang, XU Chun-di, XU Tao

2018, 26(6):  611-614.  DOI: 10.11852/zgetbjzz2018-26-06-09

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Objective To study the situation of common gastrointestinal problems among 1~12 months infants in 15 Chinese cities,and to provide theoretical basis for early-stage prevention and intervention against infantile gastrointestinal common problems. Methods Totally fifteen cities were chosen according to China′s geological and demographic distribution. Randomly cluster sampling method was used to choose a community within each city as the sample region. Infants aged 1~2 months were enrolled and their caregivers were interviewed by face-to-face questionnaire survey. Results Of 4 202 recruited infants,1 411 infants (33.6%) had common gastrointestinal problems. The prevalence of regurgitation,excessive crying,loose stools,dyschezia or dry stools were 14.4%,1.7%,23.0% and 8.5%,respectively. The prevalence of single regurgitation,excessive crying,loose stools,dyschezia or dry stools in infants with common gastrointestinal problems were 8.9%,0.7%,10.3% and 7.9%,respectively. Among complicated symptoms,the one with the highest rate was regurgitation and loose stools (4.3%);The prevalence rate peaked among infants aged 1~6 months,and the prevalence rate of regurgitation,excessive crying and loose stools dropped sharply with the age increased (P<0.05) while the prevalence rate of dyschezia or dry stools increased(P<0.05). Conclusions Gastrointestinal common problems in Chinese infants is increasingly prevalent. It is suggested to give related health education on gastrointestinal problems and feeding,thereby signifying the importance of primary prevention and intervention for infants and caregivers.

Development and assesment of Childhood Obesity Health Literacy Scale (Parental Edition)

MA Jia, YANG Li-qi, WANG Jian-qing, ZHANG Shi-chen

2018, 26(6):  615-618.  DOI: 10.11852/zgetbjzz2018-26-06-10

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Objective To develop a Childhood Obesity Health Literacy Scale (Parental Edition),and to examine the reliability and validity of the scale. Methods Based on the connotation of health literacy and the content of ending childhood obesity from WHO,the item pool of the Health Literacy Scale was designed. The scale was then administered to three elementary schools students′ parents for pre-investigation in Hefei. The validity of the scale was examined by using exploratory factor analysis and confirmatory factor analysis,and the reliability indexes of the scale and the subscales were assessed by internal consistency. Results Totally 2 170 elementary schools students′ parents were investigated in this survey. And the scale finally formed and contained 29 items after screening the items by sensibility analysis,representative analysis,independence analysis and Cronbach′s alpha coefficient. Exploratory factor analysis identified five subscales. Based on confirmatory factor analysis,the items were grouped into five subscales on health concept,including health consciousness,health knowledge,health behaviors,health cognitive and operational skills. The indicators of confirmatory factor performed well: root mean square error of approximation(RMSEA) was 0.047,root mean square (RMR) was 0.026,comparative fit index (GFI),normed fit index (NFI),relative fit index (RFI) and comparative fit index (CFI) were close to 1,showing a better model fitting. The Cronbach′s alpha coefficient for the health scale was 0.833 and the corresponding values for the subscales were 0.618~0.866. Conclusions The Childhood Obesity Health Literacy Scale (Parental Edition) is a reliable tool for assessing children′s health literacy with good reliability and validity.

Effects of exogenous pulmonary surfactant on immune function in infant with neonatal respiratory distress syndrome

QIU Jian-wu , DIAO Shi-guang , LIU Xiao-yan， ZENG Ya-li, HU Li, WANG Dong-mei, CHEN Ya-li, ZHANG Jian

2018, 26(6):  619-621.  DOI: 10.11852/zgetbjzz2018-26-06-11

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Objective To investigate the effects of exogenous pulmonary surfactant (PS) on immune function in infants with neonatal respiratory distress syndrome (NRDS),and to explore new usage of exogenous pulmonary surfactant,in order to provide new evidence and theoretical basis for prevention and treatment of neonatal respiratory distress syndrome. Method Totally 61 patients with neonatal respiratory distress syndrome were selected as the research objects. Thirty patients treated with PS were selected as the observation group, while 31 infants received no PS replacement therapy as the control group. The levels of immunoglobulin,complement and lymphocyte subtypes were measured before and after treatment in both groups. Results After treatment,the level of IgG in patients with NRDS in observation group did not significantly decrease(P>0.05),while B lymphocytes and natural killer(NK) cell increased significantly (P<0.05). However,there were no significant difference on serum IgA,IgM,complement C3,C4,Th and Ts leukomonocyte before and after treatment in the two groups(P>0.05). Conclusion Exogenous PS can improve immune function in infant with neonatal respiratory distress syndrome,and it may play a certain role in improving the therapeutic effect.

Quantitative analysis of height and weightin children with beta- thalassemia major and the associated factors

KONG Xian-ling, XIAO Sheng-ping, HUANG Xiao-hong, CHEN Ang

2018, 26(6):  622-625.  DOI: 10.11852/zgetbjzz2018-26-06-12

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Objective To quantitative analyze of the height and weight of patients with severe beta thalassaemia(β-TM) and its related factors. Methods Children with β-TM from the outpatient and inpatient in Zhongshan Boai Hospital during 2012-2016 were enrolled. According to the different genders and age,data of β-TM patients were compared with the standardization of growth curve fitting values of height and weight in Chinese children aged 0 to 18 for the quantitative evaluation of the change rule of the height and weight. The standard deviation score was calculated,while the regression model was established to analyze its correlation with gender,age,hemoglobin and serum ferritin (nearly one year′s average level). Results Totally 50 cases were included in the study,including 31 boys and 19 girls,with the average age of (7.09±3.89) years old. The level of hemoglobin(Hb) and serum ferritin(SF) were (78.60±9.85) g/L and (2 450.56±1 684.84) ng/ml respectively. The growth development of the boys,especially in 9 to 10-year-old children,obviously lagged behind normal children. The regression model revealed that children with older age(β=5.301,P<0.001) and higher level of serum ferritin (β=0.002,P=0.003) had larger gap on height with theexpected value with the standard deviation score as the dependent variable. In children who were boys (β=0.405,P=0.006),older (β=0.114,P＜ 0.001),and with higher the serum ferritin (β=0.000 1,P=0.011),the greater difference was observed between the weight of the children and the expected value. Conclusions The height and weight of children with β-TM are closely related to gender,age and serum ferritin. Compared with standardized growth curve,quantitative evaluation of the levels are of clinical significance for the prevention and control of β-TM.

Research progress on vitamin D deficiency and programming epigenetics of childhood diseases

MO Jing-jing, YANG Shu-fen

2018, 26(6):  626-629.  DOI: 10.11852/zgetbjzz2018-26-06-13

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Vitamin D plays a classical role in bone health,meanwhile is benefit to immunology,cell growth and differential. Recent evidence indicates that the level of maternal vitamin D may result in non-skeletal system diseases through programming epigenetics,including asthma,autoimmune diseases, neurocognitive disorders and so on. This review will describe the new progress on the association between vitamin D deficiency and programming epigenetics of childhood diseases.

Iron deficiency in breast feeding infants: risk factors and prevention

LI Yun-wei, WANG Dan-hua

2018, 26(6):  630-633.  DOI: 10.11852/zgetbjzz2018-26-06-14

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Breastfeeding has positive effect on growth,development,and well-being in both a short-term and a long-term perspective,which makes breastfeeding the optimal nutrition for healthy term infants. Current researches focus on maximizing the advantages of breastfeeding through protecting breastfed infants against iron deficiency in the first a few months and reducing the risk of iron deficiency. This paper reviews studies on the factors influencing iron nutrition including maternal factors,umbilical cord clamping time,gender factors,complementary food and preventive iron supplementation. Existed evidence indicates that improving mothers′knowledge on iron nutrition,iron supplementation and dietary guidance during pregnancy,delayed umbilical cord clamping will help increase iron endowment in neonates at birth; Also,exclusive breastfeeding, appropriate complementary foods for infants with different growth needs,and preventive iron supplementation for infants with high risk of iron deficiency can prevent iron deficiency in full term healthy infants.

Research progresson abnormal mealtime behavior and micronutrient levels in children with autism spectrum disorders

GUO Min, LI Ting-yu

2018, 26(6):  634-637.  DOI: 10.11852/zgetbjzz2018-26-06-15

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The main core symptoms of autism spectrum disorders (ASD) are impaired social interaction and communication,restricted interests and repetitive stereotypical behavior. The last two aspects are usually shown in eating behavior. Compared with typically developing children,autism children have more serious feeding problems. Limited food repertoire may affect the diversity of accepted food,decreasing the micronutrient levels,aggravating symptoms of autistic children. This review will summarize and discuss the abnormal mealtime behavior,micronutrient deficiency and micronutrient intervention.

Impact of the initial trauma of the adopted children and interventions

CHEN Yan-hong, WU He-ming , MIAO Shao-jiang

2018, 26(6):  638-640.  DOI: 10.11852/zgetbjzz2018-26-06-16

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Psychological problems are prevalent in adopted children,such as attachment,emotional behavior,identity issues and so on. This article discusses the possible impact of initial trauma,as well as the existing intervention mechanisms abroad. Further researches need to explore the domestic adaptability of the existing intervention mechanism.

Research progress of common observational scales forearly parent-child interaction

DING Mei-qi, XU Meng-xue, ZHU Zong-han, GUAN Hong-yan

2018, 26(6):  641-644.  DOI: 10.11852/zgetbjzz2018-26-06-17

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Providing high level of nurturing care is an important factor for young children to achieve their developmental potential. As an important index of nurturing care,Early Parent-Child Interaction has been of increasing concern. Through the observation of parent-child interaction, an objective assessment on the quality of parent-child interaction will be conducted. And it is crucial to identify strengths and problems of parenting in order to provide reasonable interventions. There are dozens of observational tools for assessing parent-child interaction internationally. Emotional Availability Scales (EAS),Parent-Child Interaction Scales (PCI Scales) and Child-Adult Relationship Experimental Index (CARE-Index) are common tools with good psychometric soundness. The background and constructs,reliability and validity,and applications of each scale reported in this review might guide clinicians and researchers working on maternal and child health care in the selection of an appropriate tool for observing parent-child interaction.

Visualization analysis of insulin resistance in overweight or obesity in children and adolescents based on citespace

QING Li, LI Xiao-nan

2018, 26(6):  645-650.  DOI: 10.11852/zgetbjzz2018-26-06-18

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Objective To explore the research hot spots of insulin resistance in overweight or obesity in children and adolescents globally. Method Related articles were searched from Web of Science core journals based on the theme of "insulin resistance in overweight or obese children and adolescents",and finally 2 587 articles were retrieved. Countries,research institutions,keywords and cited references from the 2 587 articles were analyzed by the visualization software CitespaceⅤ. Results Visualization analysis indicated that most of the articles in this field were from U.S.A. The close cooperation among different institutions was beneficial to develop the field and get more achievements. The analysis of keywords showed that the top clusters mainly focus on metabolic syndrome,insulin resistance,non-alcoholic fatty liver disease,physical and so on. Cardiovascular disease and NAFLD were the hottest spots during the recent years. Conclusions The visualization analysis contributes to realize that the region,hot spots and the problems regarding the insulin resistance in overweight or obesety in children and adolescents,thereby providing the evidence for pathophysiologic mechanism,prevention and treatments of obesity comorbidities.

Survey on the status and risk factors of sexual precocity among children aged 4~10 years in Zhenjiang district

FENG Fan, CAO Wei-ping, BAI Ling, LIN Fang-fang, XU Wen-lin

2018, 26(6):  651-653.  DOI: 10.11852/zgetbjzz2018-26-06-19

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Objective To investigate the status of precocious puberty and risk factors for sexual precocity in children aged 4~10 years in Zhenjiang. Methods A total of 3 442 children aged 4~10 years in 9 streets in Zhenjiang were investigated by questionnaire and physical examination from March 2016 to March 2017. Results Totally 42 children were diagnosed with sexual precocious puberty,including 35 cases of girls,boys in 7 cases,and the detection rate was 1.22%.The prevalence of precocious puberty in girls was 5 times higher than that of boys,and the detection rate increased with age. The incidence of precocious puberty was higher in obese and overweight children than that in normal weight group. Children taking health supplement,drinks and artificial tonic aquatic animal breeding and meat had higher prevalence of precious puberty than the control group,and the difference was statistically significant (P<0.05). Conclusions The precocious development in children is prevalent,and is correlated with the daily diet and weight change. People′s attention and the relevant measures should be taken for the prevention and health care of precocious puberty in children.

Follow-up study on hemoglobin level and its changes in 461 premature infants

ZHOU Min, WANG Xue-yin, XING Hui-yuan, ZHANG Xiao-song, ZHAO Geng-li, WANG Xu, XIE Tian, HAO Bo

2018, 26(6):  657-659.  DOI: 10.11852/zgetbjzz2018-26-06-21

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Objective To explore hemoglobin level and its changes in premature infants under corrected age of 24 months,and to provide guidance on early detection for anemia in premature infants. Method Totally 461 eligible premature infants were offered early comprehensive intervention and regularly followed up. The hemoglobin content was measured at corrected age of 1,3,6,12 and 24 months. The changes of hemoglobin level in premature infants were analyzed by using the multilevel model. Results The average content of hemoglobin in premature infants was the lowest at corrected age of 1 month,and then increased with the infants getting older,and the average content of hemoglobin at corrected age of 10 months was the same as that in full-term infants. Multilevel model results showed that the average hemoglobin content of premature infants at corrected age of 1 month was 109.40 g/L,with instantaneous rate of change of 2.05 points,while the growth rate gradually decreased. The hemoglobin content at corrected age of 1 month was different among individuals,while the rate of growth of hemoglobin content did not find any differences between individuals. Gender,birth gestational age and birth weight were not found to have effect on the hemoglobin content at corrected age of 1 month in premature infants (P>0.05). Conclusions The initial value of hemoglobin in premature infants is different,but the rate of growth is the same. Early comprehensive intervention has positive effect on maintaining hemoglobin levels in premature infants. And the hemoglobin levels of premature infants should be monitored regularly.

Current status and influencing factors for the use of supplemental vitamin D among 600 infants and toddlers

SUN Nan, LIU Qian, YANG Wen-hui, BAI Ying-de

2018, 26(6):  660-662.  DOI: 10.11852/zgetbjzz2018-26-06-22

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Objective To investigate the rate of vitamin D supplementation and related factors in children under 3 years old. Method A total of 600 children who received planned immunity and health care in child care clinic the Third Affiliated Hospital of Zhengzhou University were randomly selected in this study from January 2016 to December 2016. Self-made questionnaires were used to investigate the application of vitamin D and were filled out by main caregivers. Results The rate of vitamin D supplements for infants in Zhengzhou was 63.5%. Vitamin D supplements were started at 3 months old on average,and were stopped at 15 months old. Multi-factor Logistic regression analysis suggested that age (OR=0.816,95%CI=0.586~0.912),maternal education level (OR=0.573,95%CI=0.319~0.881) and feeding patterns (OR=0.346,95%CI=0.272~0.874) were the factors affecting the application of vitamin D supplements. Conclusions Vitamin D supplements in infants are unreasonable,and health education should be prompted in order to guide children use vitamin D supplements appropriately.

Comparison of the growth and development of Kirgiz children and adolescents between 2010 and 2014

KUANG Ming-liang, ALIMUJIANG Yimiti Taerken, AIRETI Maimaitireyimu, ADILIJIANG Selimu

2018, 26(6):  663-665.  DOI: 10.11852/zgetbjzz2018-26-06-23

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Objective To understand the status,changes and causes of the body shape of primary and middle school students of Kirgiz nationality in Xinjiang in 2010 and 2014,and to provide basis for improving the physical health of Kirgiz students. Method Data were from students who participated in the 2010 and 2014 National Student Physique and Health Survey in Xinjiang.Height,body weight and chest circumference of students aged 7 to 18 were compared. Results Height,body weight and chest circumferenceof Kirgiz boys in 2014 increased than those in 2010. The average growth values of height,body weight and chest circumference of Kirgiz male students were 1.7 cm,2.5 kg and 0.3 cm, and those values in female students were 1.4 cm,1.9 kg and 1.9 cm,respectively. The increases of height and body weight in boys was higher than those in girls,and the increase of girls′chest circumference was faster than that in boys. There were some significant differences on height,body weight and chest circumference in the age group of 7~18 years old among different years (P<0.05 or 0.01). Conclusions The body shape of Kirgiz students aged 7~18 is growing in Xinjiang,but there is still a large gap with the national average level. So more attention should be paid to take effective measures in order to improve the growth and development of Kirghiz students.

Analysis of the influencing factors for serum growth factor in children with obstructive sleep apnea hypopnea syndrome

ZHOU Jing-jing, ZHANG Qian, FAN Mao

2018, 26(6):  666-669.  DOI: 10.11852/zgetbjzz2018-26-06-24

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Objective To investigate the level of serum insulin-like growth factor-1(IGF-1),insulin-like growth factor binding protein-3(IGFBP-3) and the influencing factors for these two growth factors in children with obstructive sleep apnea hypopnea syndrome(OSAHS). Method Totally 220 children aged 3 to 6 with OSAHS and 40 children without sleep breathing disorder as controls in Kunming Children′s Hospital were enrolled in this study from July 2012 to July 2015.Participants with OSAHS were divided into mild,moderate and severe OSAHS group according to the value of apnea hypopnea index (AHI) obtained from the polysomnography (PSG). The level of serum IGF-1,IGFBP-3,body mass index(BMI),height and weight of all children were measured and compared among groups by variance analysis. The influencing factors of serum IGF-1,IGFBP-3 were determined by multiple stepwise regression analysis. Results The level of serum IGF-1 in the severe group was lower than other three groups(sever group vs. control group vs. mild group vs. moderate group:121.86±36.47 vs. 149.44±31.44 vs. 147.63±26.83 vs. 142.11±34.50,all P<0.05).The value of height in the severe group was lower than that in control group(102.64±5.95 cm vs. 105.22±6.03 cm,both P＜0.05).No significant differences were found in the level of serum IGFBP-3,BMI and weight among groups(all P＞0.05).The influencing factors for the level of serum IGF-1,IGFBP-3 in OSAHS children were the age and the lowest oxygen saturation(LSaO₂) . Conclusions The growth retardation of children with OSAHS may be related to the reduction of the level of serum IGF-1,while hypoxia is associated with the fluctuation of the serum level of IGF-1 in OSAHS children.

Influence of iron deficiency anemia on intellectual development of Han and Dongxiang Nationality school-aged children in Lanzhou city and Dongxiang county

YANG Wen-kai, MU Jing, CHEN Hong, YE Xin-hua, KANG Xi-guang, ZHANG Qian

2018, 26(6):  670-672.  DOI: 10.11852/zgetbjzz2018-26-06-25

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Objective To investigate the incidence of iron deficiency anemia (IDA) and its influence on intellectual development among the Han nationality and the Dongxiang nationality school-aged children in Lanzhou city and Dongxiang county. Methods A total of 396 children aged 6～12 were selected from two schools in Lanzhou City and Dongxiang County by random stratified sampling. The physical development indicators were measured and the blood was collected and questionnaires were investigated. The blood routineand serum iron and other indicators were analyzed. Children conformed to the diagnostic criteria were enrolled in the IDA group,healthy children with similar background were enrolled in the control group. China-Webster Children′s Intelligence Scale (C-WISC) was used to assess the intelligence of children in both groups. Results IDA prevalence rate was 8.6% in this study. The language IQ and total IQ of IDA group were lower than that of the control group,mainly in the C factor; Operating IQ of children in rural areas (Dongxiang county) was lower than that in urban areas (Lanzhou City); In IDA group,the scores of children′s jigsaw puzzles and memorize numbers in Dongxiang County were lower than those in Lanzhou city,and the difference was statistically significant. Conclusions The prevalence of IDA in children is still high in Lanzhou. IDA has a certain influence on children′s intellectual development. And there are some differences on intellectual development between children from urban and rural areas.

Analysis of physical fitness status among preschoolers aged 3~6 in Shuangliu district of Chengdu

YANG Yang, SONG Zu-ling, LIU Lu, LI Xia, CHEN Yang, ZHAO Yan-hong

2018, 26(6):  673-675.  DOI: 10.11852/zgetbjzz2018-26-06-26

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Objective To understand the physical fitness level among the preschoolers in Shuangliu district,and to explore the gender difference and age difference as well as development characteristics. Methods Stratified cluster sampling was adopted to select participants,and physical fitness examinations were conducted according to national physical fitness examination standard manual. T test was performed to compare the physical fitness aggregate score between different gender groups. Variance analysis was used to compare the physical fitness aggregate score between different age groups and Chi-square test was used to analyze the distribution of overall ranking between different ages and genders. Results A total of 1 077 preschoolers aged 3~6 were included in the study. Qualification percentage of physical fitness examination in the participants was 87.16%. As concerned with aggregate score,t test showed that statistical difference was detected in physical fitness aggregate score between different ages in both gender groups .Total score of physical fitness were different in 3.5-year-old group,4-year-old group,and 4.5-year-old group between boys and girls(Girls′physical fitness aggregate scores were higher than those of boys). As concerned with integrated ranking,Chi-square test showed that statistical difference was existed in integrated ranking distribution between different ages in both gender groups; Age groups of highest excellence rates were 5.5-year-old group and 4.5-year-old group. Girls′excellence rates were higher than those of boys in all age groups while only the difference of 4.5-year-old group was statistically significant. Conclusions Physical fitness level among preschoolers in Shuangliu district is at a lower level; Intervention among preschoolers should be tailored and individualized according to corresponding age,gender and indicators in order to enhance physical fitness level among preschoolers.

Current status and influencing factors for body mass(BMI) indes among primary and secondary school students in Lanzhou

LI Ya-hong, LIU Wei, ZHANG Jun-mei, ZHANG Rui-e, SU Jun-hai, WANG Er-ping, WANG Yu

2018, 26(6):  679-682.  DOI: 10.11852/zgetbjzz2018-26-06-28

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Objective To investigate the distribution and the influencing factors of body mass indes(BMI) in primary and middle school students in Lanzhou in 2014. Methods A total of 4 200 students aged 7～18 in Lanzhou were selected by stratified random sampling. The height,weight of students were measured to calculate BMI. The questionnaires were from the detailed measurement rules about Investigation of the Chinese Students′ Physical Fitness in Year 2010. χ² test and multivariate-Logistic regression analysis were used to analyze influencing factors. Results Totally 13.02%,73.52%,9.36% and 4.10% of the 4 200 students were with underweight,normal weight,overweight and obesity respectively. There were significant differences on BMI in children with different genders and dwelling place(P＜0.05). Multivariate-Logistic regression analysis showed students′ obesity and overweight were related to district,sex,sleeping-time,frequency of breakfast (OR=1.67,2.07,1.52,1.39,all P<0.05).And underweight in students was associated with district,sex,sleeping-time,frequency of having milk,watching TV(OR=0.71,1.31,1.56,1.40,0.81,all P<0.05). Conclusions The distribution of BMI and obesity status vary with gender,district and ages. Also,the health of primary and middle school students can be improved by strengthening health education and developing healthy diet and living habits.

Efficacy of low dose iron supplementation on prevention of premature infant anemia

ZHANG Chun-mei, ZHU Chun, TONG Mei-ling, GUO Xi-rong, ZHANG Min

2018, 26(6):  683-684.  DOI: 10.11852/zgetbjzz2018-26-06-29

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Objective To study the clinical efficacy of low dose iron supplementation on prevention of premature infant anemia. Methods A total of 68 premature infants were randomly selected as research objects from the follow-up center of high-risk infants in Nanjing Maternal and Child Health Hospital. The research group was treated with low dose of iron according to the feeding pattern of the premature infants. The breast-fed infants were supplied with oral elemental iron 2 mg/kg per day and the artificial feeding infants were supplied with oral elemental iron 1 mg/kg per day. The iron dosage of mixed-fed infants were chosen according to the proportion of formula of total milk amount(<50%,2 mg/kg;≥50%,1.5 mg/kg). Over the same period,another 72 premature infants who did not participate in follow up were chosen as control group without oral supplement of iron. The routine blood was tested when the premature infants were six months old. Results The average hemoglobin level of intervention group was higher than that of the control group (P<0.05) and the incidence of anemia in intervention group was significantly lower than that in control group (P<0.05). In addition,no significant differences on the incidence of anemia were found among infants with different feeding-pattern in intervention group. Conclusions Low dose iron supplementation based on feeding patterns can effectively improve the levels of iron storage and reduce the prevalence of anemia in premature infants.

Study on dietary behavior of middle school students in Urumqi and the correlation with overweight and obesity

Zufeiya Tuerdi, LI Wei-min

2018, 26(6):  685-687.  DOI: 10.11852/zgetbjzz2018-26-06-30

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Objective To understand the dietary behavior of middle school students in Urumqi and the relationship between dietary behavior and obesity,in order to guide the reasonable dietary behaviors of middle school students and provide basis for healthy growth. Method A total of 3 458 middle school students from 72 classes in 4 schools in Urumqi were randomly selected to complete the questionnaires by cluster sampling method in May 2016. Results The rates of eating fresh fruit frequently(87.6% vs. 54.3%),eating sweet snacks frequently(61.2% vs. 51.5%),eating vegetables frequently(93.5% vs. 91.2% ),dislike eating certain food (61.2% vs. 51.5%)in girls were significantly higher than those in boys (P<0.01). The rates of eating fresh fruit frequently(87.5%vs. 55.0%),having milk frequently(72.4%vs. 65.7%),having breakfast(86.2%vs. 83.4%) in Han students were significantly higher than those in ethnic minority students(P < 0.05).Multi-factor analysis showed that boys (OR=1.44,95% CI: 1.09~1.88),poor eating habits (OR=1.43,95% CI: 1.11~1.89),and often eating food at a roadside stall (OR=1.34,95% CI:1.08~1.73) were risk factors for overweight and obesity in middle school students. Conclusions The unhealthy eating habits of middle school students are related to obesity. It is supposed to strengthen health education on the good diet behavior to middle school students in order to promote their healthy development.

Survey on nutrition knowledge of milk products in high school students from Hetian Uygur in Xinjiang

LIU Yue-feng, CAI Xiao-di

2018, 26(6):  688-690.  DOI: 10.11852/zgetbjzz2018-26-06-31

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Objective To understand the knowledge,attitude and behavior of nutrition related to dairy products among Uygur high school students in Xinjiang,so as to provide evidence for health education to Uygur high school students in this area. Method A random cluster sampling method was used to select 1 792 Uygur Students in 35 classes of 7 high schools in Hotan City,Xinjiang,and the results were analyzed in October 2014. Results Nutritional knowledge,attitudes and behavior of rural Uygur students were poorer than those of urban students,and there were significant difference (P< 0.01). The correct answer rate of the milk nutrition knowledge in high school students was 63.63%,and the total correct rate of milk drinking behaviors was 42.38%. 12.56% of the Uygur high school students were not interested in dairy nutrition knowledge. 37.51% of the Uygur senior high school students were willing to participate in milk related nutrition knowledge activities,while 22.07% of the students were not willing to participate in related activities yet. There was a positive correlation between high school students′milk related nutrition knowledge and attitude (r=0.118,P <0.01). Conclusions The knowledge of milk related nutrition knowledge in Uygur high school students is poor and the rate of correct behavior is low,but their attitude is positive. Effective measures should be taken to improve nutrition knowledge in the future.

Analysis of evaluation methods and results of feeding practices based on 8-month-old infant

ZHOUZhuan-ning

2018, 26(6):  691-694.  DOI: 10.11852/zgetbjzz2018-26-06-32

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Objective To study the feeding practices of different household registration infants aged 8 months in surveyed area using two methods,and to find the existing problems in order to provide evidence for feeding intervention. Method A cross-sectional study was conducted. Infants aged 8 months who accepted conventional community child health services in Beijing were selected in this study in 2014.Infants with premature birth,low birth weight and congenital birth defects and heart,liver,kidney,blood diseases were excluded. Questionnaire on infant feeding practices were surveyed and analyzed. Results Complementary feeding rates before 6 months in resident and migrant infants aged 8 months were 52.0% and 65.1% (P<0.05),the mean value of 8-month-old infant feeding index of resident and migrant population were 12.42±2.24 and 11.41±2.18 (P<0.001) respectively. The qualified rate of feeding index of the resident population was better than the migrants(P=0.001). In the sub-items of the feeding index,bottle feeding index score in the past 24 hours was lower in resident population(P<0.001). In terms of complementary feeding rates in the past week,the feeding index score of milk,fish-shrimp,poultry and meat,vegetables and fruits were higher in the resident population(P<0.01).Some indicators such as early initiation of breastfeeding,minimum dietary diversity and children ever breastfed of the resident population were better than that of the migrants(P<0.05). The minimum acceptable diet of all breastfed children was lower than non-breastfed children(P＜0.01). Conclusions The feeding practices of 8-month-old infants of resident population is better than that of the migrants in the surveyed area,but the overall situation is not optimistic. Feeding index method and minimum dietary method both have their own merits.