Table of Content

10 August 2018, Volume 26 Issue 8

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Role of probiotics in the growth and development of children

ZHANG Ting

2018, 26(8):  816-818.  DOI: 10.11852/zgetbjzz2018-26-08-02

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Probiotics are live bacteria and yeasts beneficial to host. Meanwhile, probiotics involve in biological balance, biological barrier, biological oxygen capture, exemption, and play an important role in the exchange of nutrition, material, energy and information. Children, especially infants, experience the key period for the establishment of normal flora. The establishment of beneficial microbes can help resist the invasion of pathogenic microorganisms, establish good nutritional environment, improve immunity, prevent and treat the diseases. This article reviews the role and mechanism of probiotics on the growth and development of children, in order to provide new ideas and reference for the clinical application of probiotics in pediatrics.

Mediating effects of Sfrp5 and adiponectin on the association of body mass index with blood pressure in obese children

YIN Chun-yan, XIAO Yan-feng

2018, 26(8):  819-822.  DOI: 10.11852/zgetbjzz2018-26-08-03

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Objective To examine the mediating effects of changes in adipocytokine levels on the association between body mass index (BMI) and blood pressure (BP) among obese children with hypertension. Methods A total of 120 obese children treated in the Second Affiliated Hospital of Xi′an Jiaotong University from June 2012 to August 2014 were enrolled in this study.And children with high blood pressure were intervened for six months on life style.Anthropometric data(including height, weight, waistline, BMI and BP), adiponectin,chemerin,leptin,Sfrp5,Wnt5a,hsCRP and TNF-α were assessed at baseline and after 6-month lifestyle intervention.Mediation analysis was conducted to examine whether the association between BP reduction and weight loss was mediated by changes in adipocytokines (ΔSfrp5, Δadiponectin, Δchemerin or ΔhsCRP) on the independent variable (ΔSBP or ΔDBP). Results Serum levels of Sfrp5 and adiponectin were significantly lower in obese children with hypertension, but serum levels of Wnt5a, hsCRP and chemerin were higher in obese children with hypertension(P＜0.05).There was no significant difference on the levels of TNF-α between obese children with hypertension and without hypertension(P＞0.05).The levels of adiponectin and Sfrp5 increased after intervention, while the levels of chemerin, leptin, Wnt5a,hsCRP decreased after intervention(P＜0.05).The changes in Sfrp5 and adiponectin showed a partial mediating effect on the relationship between weight loss and BP reduction after controlling for covariates, while the changes in chemerin and hsCRP had no mediating effect. Conclusion Sfrp5 and adiponectin have a certain mediating effect on the increase of blood pressure in obese children.

Status and influencing factors of infants feeding in poor rural areas of southern Shaanxi Province

YANG Ji-you,YUE Ai

2018, 26(8):  823-826.  DOI: 10.11852/zgetbjzz2018-26-08-04

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Objective To understand the status of food feeding and risk factors for infants in poor rural areas, in order to provide reference for improving family feeding behavior in poor rural areas. Methods Based on the basic personal information, family basic information and feeding behaviors information collected in poor rural areas in 1 354 infants aged 18~24 months. Descriptive analysis and multi-variate OLS regression analysis were used to analyze data. Results 1) The ratio of food and feed supplement trace elements can not meet minimum requirements of the WHO standard diet diversity, minimum food frequency standard, minimum acceptable standard diet ratio were 18.09%, 37.81% and 66.17%, respectively.The ratio of never adding trace elements (iron) was as high as 73.26% after birth.2) Only child, mother as the guardian, maternal education level, and unavailability for minimum living allowances were positively correlated with the nutrient elements supplement behavior. Conclusion Feeding knowledge is supposed to be strengthened in order to improve the feeding behavior of infants in rural areas, and ultimately to promote children′s health and cognitive development.

Study on the correlation among serum 25-(OH)D₃ level, the severity and immune function of community-acquired pneumonia in children

QIAN Jing, YUAN Yi

2018, 26(8):  827-830.  DOI: 10.11852/zgetbjzz2018-26-08-05

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Objective To investigate the serum levels of 25-(OH)D₃, humoral immunity and cellular immunity in children with severe and mild pneumonia, and to explore the correlation among serum 25-(OH)D₃ level,the severity and immune function of community-acquired pneumonia (CAP) in children. Methods A total of 175 CAP patients were enrolled in Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2016 to March 2017,and were divided into severe pneumonia group(n=87) and mild pneumonia group(n=88).Also,100 healthy children whoperformed health examination in this hospital were selected as control group by random number method.The levels of serum 25-(OH)D₃, white blood cell count, neutrophil and lymphocyte ratio, C-reactive protein(CRP),procalcitonin(PCT), humoral immunity (IgA, IgG, IgM), and cellular immunity(CD4, CD8, CD19, CD16/56) were measured.And the correlations among serum 25-(OH)D₃ level, inflammatory cells and immune function were analyzed. Results The levels of serum 25-(OH)D₃ were significantly different among severe pneumonia group,mild pneumonia group and control group(F=76.95, P<0.05).There were significant differences on the white blood cell count, CRP, PCT and IgG levels between severe pneumonia group and mild pneumonia group(all P<0.05).Pearson analysis indicated that serum 25-(OH)D₃ level was negatively correlated with total white blood cell count(r=-0.307, P<0.05).Multifactor analysis showed that 25-(OH) D₃ and IgG levels were the risk factors of severe community-acquired pneumonia in children. Conclusions Serum 25-(OH)D₃ and IgG levels are associated with CAP in children.The levels of serum 25-(OH)D₃ and IgG in children with severe pneumonia are significantly lower than those in mild pneumonia group.So it is of great significance to test serum levels of 25-(OH)D₃ and IgG for early assessment of pneumonia.

Research on asthma children′s neutrophil to form extracellular traps induced by nitric oxide donor

LI Wen-xuan, ZHU Yun-qian, WANG Xiao-ming

2018, 26(8):  831-834.  DOI: 10.11852/zgetbjzz2018-26-08-06

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Objective To investigate the inductive effect of nitric oxide donor on asthmatic children′s neutrophil extracellular traps (NETs),in order to find new monitoring indicators and therapeutic targets that may be used in childhood asthma. Methods Totally 38 children with bronchial asthma in the Pediatric Department of the Fifth People′s Hospital of Shanghai were enrolled in this study from September to November in 2017. Percoll density gradient centrifugation was used to isolate neutrophils from the peripheral blood of asthmatic children, and nitric oxide donor (SNP) was added for in vitro incubation.Fluorescent staining was used to detect the double-stranded DNA (the main component of NETs) in the cell supernatant for quantitative analysis.Meantime, the cell slides were prepared to observe the main structures of NETs by fluorescence microscopy.In addition, inhibitors of nitric oxide synthase (NOS) were used to interfere the induction of SNP. Results The neutrophils were successfully isolated from the peripheral blood of asthmatic children, and the recovery rate was over 95%, the cell viability was over 80%.The extracellular mesh-like NETs structures were obviously observed in 3 hours after induction in PMA and SNP group, but NETs structure was not observed in PBS, SNP + L-NAME and SNP + SMT groups.The relative amounts of NETs in the intervention group (PMA 160 nmol/L, LPS 100 ng/ml and SNP 400 μmol/L) were significantly higher than those in the negative control PBS group (P＜0.05).The relative amounts of NETs in SNP + NOS blockers group (SMT 10 mmol/L, L-NAME 500 mol/L and L-NMMA 1 mmol/L) were less than simple SNP group (P＜0.05).NOS inhibitor could reduce but could not completely block the generation of NETs (P＜0.05).The relative generation of NETs at 1 h, 2 h, 3 h induced by SNP kept increasing while the formation decreased at 3 h with PBS(P＜0.05).With the prolongation of L-NAME, the relative amount of NETs induced by SNP decreased continuously(P＜0.05). Conclusion SNP can induce the formation of NETs in asthmatic children, and inhibitors of NOS can reduce the generation of NETs, which provides a new idea for the monitoring and treatment of childhood asthma.

Association of LTC4S gene polymorphisms with childhood asthma and responsiveness to montelukast

LIAO Shi-e,WEI Bing,MA Ming,WANG Xue-na,WEI Ke-lun,ZHU Hua,YU Cong,ZHAO Song

2018, 26(8):  835-838.  DOI: 10.11852/zgetbjzz2018-26-08-07

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Objective To study the association between the single nucleotide polymorphisms(SNPs) of leukotriene C4 synthase (LTC4S) rs730012 or rs3776944 and the severity, responsiveness to montelukast in childhood asthma, in order to guide clinical prevention and precise treatment. Methods Sequence specific primers-polymerase chain reactions (PCRs) were used to assess the SNPs of 215 asthma children and 228 non-asthma children in the General Hospital of Shenyang Military Command from May 2016 to August 2017.And the associations among the SNPs of rs730012, rs3776944 and pulmonary function,LTE4 in urine,Childhood Asthma Control Test(C-ACT) score were analyzed. Results 1)No significant differences were found in genetype frequency of rs730012 and rs3776944 between case group and control group (χ²=0.079,0.617,both P＞0.05).2) The genetype frequency of A/C and C/C in moderate or severe asthma group was significantly higher than that in control group and mild asthma group(χ²=4.129,6.088,both P＜0.05).3) The improvement of FEF50、FEF75 in A/C and C/C genotype asthma children after treatment were significantly higher than that in asthma childrenwith A/A genotype (all P＜0.05),while the difference was not found in children treated only by budesonide (P＞0.05).4)The efficacy of montelukast was better in asthma children with A/A genotype.Meantime, changes of uriny LTE4 in A/C and C/C genotypes were higher, and significant differences were found in rs730012, rs3776944(all P＜0.05). Conclusion The SNP of LTC4S rs730012 is associated with the severity level of asthma.And the efficacy of montelukast in patients with wild type of rs730012 or rs3776944 is better.

Effect of hypothyroidism in pregnancy on thyroid stimulating hormone of heel blood in neonates

LONG Wei, YANG Yu-qi, ZHOU Wen-bai,GUO Fang,ZHOU Hong,ZHANG Bin, LIU Jian-bing, YU Bin

2018, 26(8):  839-842.  DOI: 10.11852/zgetbjzz2018-26-08-08

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Objective To analyze the effect of hypothyroidism in pregnancy on thyroid stimulating hormone (TSH) of heel blood in neonates. Methods A total of 191 neonates delivered by pregnant women with hypothyroidism were enrolled in case group, and 9 839 neonates delivered by healthy pregnant women were collected as control group from April 2015 to April 2017.Neonates′ heel blood was collected, and blood levels of TSH were measured.The concomitant variables of neonatal heel blood TSH were screened by univariate analysis, and the effect of hypothyroidism in pregnancy on neonatal TSH level was assessed by multiple linear regression. Results The level of TSH in neonates was associated with maternal age, gestational age, blood collection time after birth, gender and hypothyroidism in pregnancy.The false positive rate of congenital hypothyroidism (CH) screening in neonates delivered by pregnant women with hypothyroidism increased to 4.19% notably.Multifactor analysis showed that hypothyroidism in pregnancy was a risk factor for TSH level increase in neonatal heel blood (β=0.78,95% CI:0.42~1.14,P<0.001). Conclusion Hypothyroidism in pregnancy is a risk factor for TSH level increase in neonatal heel blood, and it may increase the false positive rate of CH screening in neonates.

Influence of delayed cord clamping on the outcome of moderate and late preterm infants

ZHANG Liang, ZHANG Yong-feng, ZHANG Wen-hua,LIU Shu-hua,HAO Xian

2018, 26(8):  843-845.  DOI: 10.11852/zgetbjzz2018-26-08-09

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Objective To investigate the influence of delayed cord clamping (DCC) on the outcome of moderate and late preterm infants(MPIs), in order to provide reference for improring the outcome of MPIs. Methods Totally 116 cases of moderate and late preterm infants delivered in the Affiliated Hospital of Weifang Medical University from January 2016 to January 2017 were randomly divided into delayed cord clamping(DCC)group (n=55) and early cord clamping (ECC) group (n=61).The Apgar score of 1 min and 5 min, the level of hemoglobin (Hb) and hematocrit(HCT) in 12 hours,1 week and 4 weeks after birth, bilirubin peak, the time for bilirubin arriving peak, and the incidence rates of anemia, blood transfusion, erythrocytosis, intracranial hemorrhage, sepsis and respiratory distress syndrome (RDS) were compared between DCC group and ECC group. Results The levels of hemoglobin and hematocrit in 12 hours,1 week and 4 weeks after birth in DCC group were significantly higher than those in ECC group (all P<0.05).The incidence rates of anemia in 4 weeks after birth and blood transfusion during hospitalization in DCC group were also significantly lower than those in ECC group (all P<0.05).However, there were no significant differences on the Apgar score of 1 min and 5 min, bilirubin peak, the time for bilirubin arriving peak, and the incidence rates of erythrocytosis, intracranial hemorrhage, sepsis, RDS between DCC group and ECC group (P>0.05). Conclusions Delayed cord clamping can increase hemoglobin and hematocrit levels in moderate and late preterm infants, reduce the incidence of anemia and blood transfusion. Meantime, delayed cord clamping do not increase the incidence of complications, so it can be used to improve the outcome of moderately and late preterm infants.

Status and influencing factorsof timely vaccination rate of the first dose of hepatitis B vaccine for children aged 0~35 months from 14 counties in western China

LIU Xiao-li, YANG Chen-lu, ZHOU Hong

2018, 26(8):  846-848.  DOI: 10.11852/zgetbjzz2018-26-08-10

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Objective To understand the timely vaccination rate of the first dose of hepatitis B vaccine (HepB1) and its related factors in some areas of western China. Methods A cross-sectional study with three-stage stratified random sampling method was conducted from September to October in 2011, and a total of 2 999 children aged 0~35 months in 14 counties of western China were chosen to provide information on their first dose of hepatitis B vaccine from "vaccination certificate". Results The vaccination rate of HepB1 and the timely vaccination rate of HepB1 were 99.3% and 68.5% respectively. Univariate analysis showed that gender, ethnicity, age, birth place, household net income per capita, caregiver′s educational level, and low birth weight were significantly correlated with the timely vaccination rate of HepB1 (P<0.05); Multivariate analysis indicated that low birth weight (OR=3.182, 95%CI: 2.129~4.756) and birth in home and other places except hospital (OR=4.691, 95%CI: 2.824~7.794) were the factors associated with of the timely vaccination rate of HepB1. Conclusions The vaccination rate of HepB1 is high in the investigated areas, while the timely vaccination rate of HepB1 is relatively low. Improving the hospital delivery rate and strengthening the correct understanding of contraindications for hepatitis B vaccination are the key to improve the timely vaccination rate of HepB1.

Effect of saccharomyces boulardii and early intervention on NF-kB expression in brain tissue, learning and memory in neonatal rats with hyperbilirubinemia

GUO Shuang, LI Xiao-jie, TAO De-shuang, ZHANG Shang, LI Meng-qing, ZHANG Yi-wen

2018, 26(8):  849-853.  DOI: 10.11852/zgetbjzz2018-26-08-11

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Objective To discuss the effect of saccharomyces boulardii and early intervention on NF-kB expression in brain tissue, as well as learning and memory in neonatal rats with hyperbilirubinemia. Methods A total of 88 SD rats aged 7 days were randomly divided into the control group (NS group) and experiment group (T1,T2 and T3 group), with 22 rats in each group. The experiment group was intraperitoneally injected with 50 μg/g bilirubin at 7 days and 10 days respectively, and the control group was injected intraperitoneally with equal volume of normal saline. After the last injection of 12 h, 6 neonatal rats were randomly selected in each group, and the bilirubin contents in the brain and serum were measured. Meantime, group T1 was treated with saccharomyces boulardii, and group T2 was treated with saccharomyces boulardii and early intervention, group T3 was untreated till 28 days old. HE was used to observe the pathological changes of brain tissue, the NF-kB positive cells were observed by immunohistochemical staining, and morris water was used to evaluate the latency and the times crossing target quadrants. Results The bilirubin contents in the brain and serum of NS group with 10-day-old rats were significantly lower than those in the experiment group (P<0.01), but there was no significant difference among the experiment groups (P>0.05). The bilirubin contents in the brain and serum of NS group with 28-day-old rats were significantly lower than those in group T1, T2 and T3, and the bilirubin contents in the brain and serum in group T1 were significantly lower than those in group T1 and T3 (P<0.05). HE results showed that the neurons of NS group had complete structure, but the number of neurons in group T1,T2 and T3 were decreased and with bilirubin deposits. The number of NF-kB positive cells in NS group were significantly less than those in group T1,T2 and T3 (P<0.01), and were also less in group T2 than that in group T1 and T3 (P<0.05). The latency and the times crossing target quadrants in NS group were significantly better than those in group T1、T2 and T3 (P<0.05), and were also better in group T2 than that in group T1 and T3 (P<0.05). Conclusion Saccharomyces boulardii and early intervention can effectively reduce expression of NF-kB in brain tissue and improve learning and memory in neonatal rats with hyperbilirubinemia.

Pesearch progress on the effect of prebiotics on intestinal mucosal immunity and allergic diseases

YAO Wei-ming, XING Meng-juan, HU Yan

2018, 26(8):  854-857.  DOI: 10.11852/zgetbjzz2018-26-08-12

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Early preventive strategies of allergic diseases are beneficial to block the allergy march and to improve the quality of life. Most studies have shown that prebiotics, similar to human milk oligosacharides, might involve into intestinal mucosal immunity regulation by impacting intestinal flora species or quantity, producing short chain fatty acids and so on, thereby triggering allergic diseases. Although there is no consistent conclusion about the effect of prebiotics on immunity regulation and allergy prevention, more and more evidence show that prebiotics intervention seems to be one of the most important strategies to prevent allergic diseases.

Progress on application of bi-level continuous positive airway pressure in respiratory support of premature infants

ZHANG Hui-jie, WEN Xiao-hong

2018, 26(8):  858-861.  DOI: 10.11852/zgetbjzz2018-26-08-13

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Respiratory diseases are the most common in preterm infants,some need respiratory support with various treatment methods after birth.Nowadays, more attention is paid to reduce complications in its treatment, especially chronic lung disease like bronchopulmonary dysplasia, and the impact on quality of the life of premature infants.The efficacy of non-invasive ventilation in the treatment of respiratory diseases of premature infants is confirmed.This review summarizes the application of bi-level positive airway pressure ventilation in premature infants with respiratory diseases in recent years.

Research progress on the correlation between protein gene in enamel and dental caries in children

LIU Qiong,QIAN Hong

2018, 26(8):  862-864.  DOI: 10.11852/zgetbjzz2018-26-08-14

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Caries are the most common disease in children.Dental caries in children are not self-healing, and if the disease develops, they will cause local pain and abscess, thereby resulting in chewing difficulties, sleep difficulties, and even affecting children′s growth.There are many causes of caries:bacteria, unhealthy diets, poor oral hygiene habits and so on.Recently, more and more scholars have found that the occurrence of caries is closely related to the susceptibility of host, and researches mainly focus on the protein in enamel.This article reviews the progress on the correlation of polymorphism of protein gene in enamel with the occurrence of children dental caries.

Research progress on toxicology, clinical diagnosis and treatment of metallic mercury intoxication in children

SHI Xiao-qing, HE Xi-yu,WU Hong-lin

2018, 26(8):  865-868.  DOI: 10.11852/zgetbjzz2018-26-08-15

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Metallic mercury is widely used in human′s life, but it can cause different toxicity damage to human′s body.Metallic mercury mainly enters body through respiratory tract in the form of mercury vapor.It can also be absorbed through the skin, subcutaneously, intramuscularly, and intravenously, and the absorption the digestive tract is negligible.It mainly accumulates in the brain stem, cerebellum and kidney, causing damage to the central nervous system and kidney.Mercury poisoning can be treated with metal chelators, hemodialysis, plasma exchange and surgical resection, and meantime monitoring the repair of various system injuries.The toxicological mechanism, clinical manifestations, diagnosis and treatment progress of metallic mercury intoxication in children is discussed in this paper.

Research progress on physiological and pathological factors of infant cry

XU Xuan-pei, ZHANG Li, QU Yi, MU De-zhi

2018, 26(8):  869-872.  DOI: 10.11852/zgetbjzz2018-26-08-16

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Infant cry is of great significance.In addition to transmitting information, infant cry also plays an irreplaceable role in improving the nurturing behavior, establishing relationships with nurseries early and participating in early childhood language learning.Researchers have been trying to apply the analysis of infant cry to the clinic, seeking pathological information in infant cry since the last century.Analysis of the cry of autism children, sudden infant death syndrome and vocal-fold motion impairment is expected to be one of the early tools for easy screening, and has clinical applications in the treatment of colic and pain.This review summarizes the influencing factors of infant cry and the characteristics of cry in related diseases, in order to provide reference for their clinical applications.

Meta-analysis of the effect of probiotics supplementation during pregnancy and early infancy on preventing children eczema

HUANG La-fang, HE Zhen,YIN Dao-gen,WANG Qing-chuan, LIAO Xiao-bing, DUAN Xue-yan

2018, 26(8):  873-877.  DOI: 10.11852/zgetbjzz2018-26-08-17

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Objective To evaluate the effect of probiotics supplementation on preventing children eczema systematically. Methods Randomized controlled trial studies regarding the effect of probiotics supplementation during pregnancy and early infancy on preventing children eczema since 2000 were analyzed by Meta-analysis with Rev Man 5.3 software.The fixed effect model or random effect model was selected by the heterogeneity test results.The RR value and 95%CI were calculated,publication bias was evaluated, and sensitivity analysis was conducted.Subgroup analysis was conducted according to different strains and different end time of follow-up. Results Totally 23 published articles were selected, including 3 004 intervention cases and 3 016 control cases.The RR and 95%CI of probiotics supplementation preventing children eczema was 0.76(95%CI:0.65~0.89) (P＜0.05);Subgroup analysis revealed that the RR and 95%CI of probiotic mixtures was 0.56(95%CI:0.41~0.78)(P＜0.05);The end time of follow-up for≤12 months and ≤24 months were 0.69(95%CI:0.51~0.93) (P＜0.05) and 0.77(95%CI:0.60~0.98) (P＜0.05), respectively. Conclusions In order to prevent children atopic eczema, probiotics supplementation during pregnancy and early infancy should be promoted.Moreover, probiotic mixtures with Lactobacillus and Bifidobacterium are the best choice.

Establishment of cut-off value for newborn genetic metabolic disease screening by tandem mass spectrometry in Ningxia

LI Shu-hong, MAO Xin-mei, SHEN Dan, JING Miao, GAO Jin-li, MA Yu-lan

2018, 26(8):  878-881.  DOI: 10.11852/zgetbjzz2018-26-08-18

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Objective To establish the cut-off value of amino acids, organic acids and aliphatic acids for newborn genetic metabolic disease screening in Ningxia, in order to provide theoretical basis for the laboratory diagnosis of neonate genetic metabolic diseases. Methods With non-derivative pretreatment of dry blood spots sample, tandem mass spectrometry method was adopted to detect amino acids, organic acids and aliphatic acids concentration in the whole blood samples of 45 602 neonates up to standard in Ningxia.Quality control products were from the two batches of kit and the U.S.centers for disease control.The percentile method was used to establish the cut-off value and identified P₁~P₉₉ as normal reference range.Wilcoxon rank sum test was performed to analyze the difference of cut-off value between Ningxia and Shanghai Xinhua hospital. Results Among 45 602 neonates who were screened,31 cases were diagnosed as postive,20 cases with HPA,1 case with MSUD,2 case with high methionine anemia,1 case with CTLN1,3 case with MMA,1 case with IVA,1 case with SCADD,1 case with MCAD,1 case with CPTII. Compared with the cut-off value of Shanghai Xinhua Hospital, the measurements of arginine,glycine,tyrosine,ornithine,leucine,valine,lsopentyl carnitine,twelve corbonyl carnitine,C0/(C16+C18) and so on were significautly different. Conclusion With the number of screening increasing and the range of screening expanded, more experience and positive predictive value will be accumulated to adjust the cut-off value of relevant measurements.

Efficacy of caffeine citrate for preventive use in the prophylactic treatment of primary apnea and related complications in premature infants

KE Hua, LI Zhan-kui, GUO Jin-zhen

2018, 26(8):  882-884.  DOI: 10.11852/zgetbjzz2018-26-08-19

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Objective To analyze the efficacy of caffeine citrate for preventive use in the prophylactic treatment of primary apnea and related complications in premature infants. Methods The preterm infants born in Northwest Women′s and Children′s Hospital from June 2014 to May 2017 and with gestational age under 32 weeks and birth weight under 1 500g after birth were randomly divided into caffeine citrate prevention group(n=539) and treatment group(n=557).Children began to use caffeine citrate immediately after birth in the prevention group, while started to use caffeine citrate after the onset of primary apnea after birth in the treatment group.The rate of apnea, the duration time for using oxygen and invasive and non-invasive mechanical ventilation, as well as the incidence of bronchopulmonary dysplasia(BPD),intercranial hemorrhage(ICH),necrotizing enterocolitis(NEC) and retinopathy of prematurity(ROP) were compared between prevention group and treatment group. Results The rate of the apnea and the duration time for oxygen, invasive and non-invasive mechanical ventilation in the caffeine citrate prevention group were significantly lower than those in the treatment group [10.0% vs.19.7%,(29.0±4.7)d vs.(35.0±4.2)d,(1.0±1.7)d vs.(2.6±1.5)d,(1.7±1.2)d vs.(2.4±1.3)d, all P<0.05].The incidence rates of BPD, ICH, NEC and ROP in the caffeine citrate prevention group were also significantly lower than those in the treatment group(11.7%vs.16.2%,10.0%vs.14.7%,5.2% vs.8.8%,9.1%vs.13.2%, all P<0.05). Conclusion Preventive use of caffeine citrate for use in the prophylactic treatment can significantly reduce the incidence of apnea and related complications.

Oral ibuprofen treatment in preterm infants with patent ductus venosus:a feasibility study

HUANG Zhi-yong, ZHUANG Xiao-zheng, LUO Wei-quan, WU Hao-tang, LIANG Jian-feng

2018, 26(8):  885-889.  DOI: 10.11852/zgetbjzz2018-26-08-20

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Objective To test the feasibility of oral ibuprofen treatment in preterm infants with patent ductus venosus(PDV). Methods A total of 90 neonates hospitalized with neonatal jaundice and diagnosed with PDV by echocardiography within 24 hours after birth were enrolled in this study from March 2016 to July 2017.And participants were randomly divided into the treatment group(n=45) and control group(n=45).The treatment group was orally administered ibuprofen of 10 mg/kg within 24 hours after birth, followed 24 hours later by the second dose of 5 mg/kg and 48 hours later by the third dose of 5 mg/kg.While the control group was treated with placebo(normal saline) of 1 ml/kg, followed 24 hours later by the second dose of 0.5 ml/kg and 48 hours later by the third dose of 0.5ml/kg.The total bilirubin (TB), direct bilirubin (DBIL), indirect bilirubin (IBIL) and serum ammonia levels were tested before and after treatment in two groups.The two groups were examined by echocardiography after treatment, also the efficacy and adverse reactions of the two groups were observed after treatment. Results 1)The rate of closure of ductus venosus in the treatment group was significantly higher than that in the control group (77.8% vs.22.2%, P＜0.01).2)The levels of TB, DBIL, IBIL and blood ammonia after treatment in the treatment group were significantly lower than those in the control group (P＜0.01).3) In terms of adverse reactions,the differences on positive rate of fecal occult blood, the rates of intracranial hemorrhage, necrotizing enterocolitis,oliguria and feeding intolerance between two groups were not significant (all P＞0.05).Also, the levels of platelet and creatinine in two groups were not significantly different (P＞0.05). Conclusion Oral administration of ibuprofen can effectively promote the closure of PDV with clinical application of relative safety.

Application of pulmonary surfactant combined with nasal continuous positive airway pressure ventilation in the treatment of premature infants with hyaline membrane disease

ZHANG Xiao-bo

2018, 26(8):  890-892.  DOI: 10.11852/zgetbjzz2018-26-08-21

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Objective To investigate the effect of alveolar surfactant combined with nasal plug continuous positive airway pressure ventilation in the treatment of pulmonary hyaline membrane disease in preterm infants. Methods Totally 50 cases treated in Huangshan People′s Hospital from November 2014 to November 2017 were enrolled in this study.The participants were divided into two groups, the control group (n=24) was given nasal continuous positive airway pressure therapy, and the experimental group (n=26) was treated with pulmonary surfactant combined with nasal continuous positive airway pressure ventilation.Blood gas analysis index, incidence of complications and respiratory mechanics of the two groups were collected and compared. Results Percutaneous oxygen saturation(SpO₂), partial pressure of oxygen(PaO₂), partial pressure of carbon dioxide (PaCO₂) and hydrogen ion concentration (pH) in experimental group were better than those in control group after treatment (P＜0.05).Also, the levels of breathing time constant (RCexp) and peak expiratory flow (PEF) were significantly higher in the experimental group than those in the control group(P＜0.05).The complication rate of experimental group was 7.69%, which was significantly lower than that of control group (28%)(P＜0.05). Conclusion Pulmonary surfactant combined with nasal continuous positive airway pressure can effectively improve the blood gas analysis index, increase RCexp and PEF in preterm infants with pulmonary hyaline disease, thereby reducing complications and improving prognosis.

Analysis of risk factors for recurrent wheezing in infants and clinical significance of Tidal breath analysis for infant pulmonary function testing

NIE Ying, LI Jing-feng, LIAO Xing-juan, XU Hui-fu

2018, 26(8):  893-896.  DOI: 10.11852/zgetbjzz2018-26-08-22

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Objective To analyze the risk factors of recurrent wheezing in infants, and to evaluate its correlation with tidal breathing pulmonary function. Methods Infants with “recurrent wheezing” over three times hospitalized in the Department of Pediatrics of the First Hospital of Wuhan were enrolled in observation group from March 2015 to March 2017.Meanwhile, healthy children in outpatient were selected as control group.Questionnaires were used to analyze risk factors of recurrent wheezing.Tidal breathing pulmonary function was tested at admission (acute phase) and discharge (remission phase).And respiratory rate(RR), TV/kg、Ti/Te、TPTEF/TE、VPEF/VE of two groups were tested. Results 1) Eczema (OR=5.86,95%CI:1.72~22.06), secondhand smoking (OR=2.16, 95%CI:1.36~5.29), parents′ history of asthma or allergic rhinitis (OR=7.83, 95%CI:2.56~30.31), city residence(OR=3.12,95%CI:1.17~12.46) and dwelling adjacent to road (OR=2.05,95%CI:1.08~3.03) were the independent risk factors for recurrent wheezing.2) Compared with the control group, RR was significantly faster in both acute stage and wheezing stage of wheezing group (both P<0.05); RR in wheezing remission stage was significantly lower than that in acute wheezing stage(P<0.05).TPTEF/TE and VPEF/VE were significantly lower in both acute wheezing stage and wheezing remission stage than those in control group (both P<0.01).After positive treatment, TPTEF/TE and VPEF/VE in wheezing remission stage were significantly higher than those in acute wheezing stage (both P<0.05). Conclusions Eczema, secondhand smoking, parents′ history of asthma or allergic rhinitis, city residence and dwelling adjacent to road are the independent risk factors for recurrent wheezing.Tidal breathing analysis of pulmonary function may be a reliable and Objective indicator for clinical diagnosis of asthma in infants.

Investigation and analysis of pulmonary function of students in Grade three of middle school in Jiujiang

WANG Long-hui, DING Guo-biao, XING Jing, REN Hui-jiao

2018, 26(8):  897-899.  DOI: 10.11852/zgetbjzz2018-26-08-23

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Objective To analyze the pulmonary function of students in Grade three of middle school in Jiujiang, in order to provide basis for health education to students. Methods A total of 1 240 students in Grade three of middle school who took physical examination in Maternal and Child Health Care Hospital of Jiujiang from June 2015 to June 2017 were selected into this study.Pulmonary function including vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow rate forced expiratory flow (PEF), forced expiratory flow 25 (FEF25), forced expiratory flow 50(FEF50), forced expiratory flow 75(FEF75) and maximal mid-expiratory flow (MMEF) were assessed and compared among different year, age, gender and body mass index(BMI) groups. Results Pulmonary function of students decreased from 2015 to 2017(P<0.05).Pulmonary function increased with the increase of age (P<0.05).Male students generally had higher level of lung function than female ones (P<0.05).In terms of BMI, pulmonary function was higher in group of 18.5~24.9 kg/m² than that in groups of BMI under 18.5 kg/m² and over 24.9 kg/m² (both P<0.05).The FVC, FEV1 and FEF75 of the group with BMI under 18.5 kg/m² were higher than those of group with BMI over 24.9 kg/m², while other lung function parameters between the two groups had no significant differences(P<0.05). Conclusions Pulmonary function of students tends to decrease year over year.Children who are older, male have higher pulmonary function.While pulmonary function of the overweight or underweight students is lower than that of the normal ones.Therefore, students are suggested to strengthen their physical activities in order to improve their pulmonary function.

Analysis on the familial influencing factors of myopia among students in junior middle school

ZHANG Yan-qing, ZHANG Qian, LIU Jie, ZHENG Qian,MENG Gang

2018, 26(8):  900-902.  DOI: 10.11852/zgetbjzz2018-26-08-24

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Objective To evaluate the factors associated with myopia in junior middle school students in Zibo city, and to provide reference on myopia prevention and control among students. Methods A total of 1 036 students were selected in April 2016 using a stratified cluster sampling method from first grade and second grade of junior middle schools in Zibo City. Students underwent diopter examinations and their parents completed detailed questionnaires. Results The average prevalence of myopia was 73.24%, of which the prevalence rate of mild myopia was 47.77%, moderate myopia was 22.79% and severe myopia was 2.68%.There were statistically significant differences on myopia prevalence in different grade and gender groups (P<0.05). Students born at full terms, with correct sitting position at home, participating in sports training and with parents led to have eyes examined more than twice a year were significantly associated with a lower risk of myopia (all P<0.05). Moreover, students used to reading book on the bed had a higher risk of myopia(P<0.05). Conclusion Myopia of students in junior middle school is highly prevalentin Zibo city. So developing good habit of eyes using may be the key to prevent and treat myopia in students.

Epidemiological trend of measles from 2009 to 2016 among children in Urumqi

SONG Fang, LIAO Xiu-feng, LIANG Jing

2018, 26(8):  903-905.  DOI: 10.11852/zgetbjzz2018-26-08-25

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Objective To investigate the epidemiological characteristics of measles children in Urumqi, in order to provide scientific basis for further control and elimination of measles. Methods Descriptive epidemiological method was used to analyze the epidemiological characteristics of measles among children in Urumqi from 2009 to 2016. Results A total of 1 104 cases of measles were reported in Urumqi from 2009 to 2016, and the average incidence rate was 19.96/10⁵. The sex ratio of male to female is 1.35∶1, and the number of measles cases in Tianshan district ranked the first. The seasonal epidemics of measles was obvious, and the peak period was April to June. Measles mainly occurred in children under 2 years old. 73.33% of cases were without immune history. Conclusions Vaccine is recommended as a fundamental measure to eliminate measles, and improving the timely vaccination rate can reduce the risk of measles infection in children at lower age stage. So revaccination of measles vaccine for women of childbearing age is considered to effectively improve maternal antibody levels in newborns.

Investigation on the use of child restraint system of family car by field observation

LI Wei-yi, GAO Shu-na, HE Li-hua, WU Ming-yu, DU Juan,CHEN Ming-ling, LING Qing, WANG Ye-jing

2018, 26(8):  906-908.  DOI: 10.11852/zgetbjzz2018-26-08-26

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Objective To investigate the use of child restraint system (CRS) and children′ riding behavior in Shanghai Huangpu district. Method A total of five kindergartens, one pediatric hospital and four shopping malls were investigated by field observation from April to June 2017. Results Only 40 of 838 children used CRS,and the CRS usage rate was 4.8%.Also, 69.2% (580/838) of children sat in the back row of the car without any restraint system, and 21.1% (177/838) of children were hugged by parents.57 (6.8%) children were in the passenger seat, of which 9 were held by their parents.The CRS usage rates in different observation sites were significantly different (χ²=723.518,P<0.001),while the CRS usage rates at hospital was the lowest (3.3%,14/422).The usage rate of CRS in SUV was 7.5% (14/187),which was significantly higher than other types of vehicles(χ ²=79.502,P<0.001).The CRS usage rate in cars with one passenger was significantly higher than that in cars with more passengers(χ²=15.032,P<0.001). Conclusions The CRS usage rate was low in Huangpu district.It is suggested to take effective measures to improve parents′correct cognition of child riding safety, so as to popularize the correct use of CRS.

Analysis on clinical features of 105 children with acute poisoning

WANG Ai-li, ZHANG Hui-qin,ZHANG Jing-jing,CAO Yu-hong,ZHANG Yue-ping

2018, 26(8):  909-912.  DOI: 10.11852/zgetbjzz2018-26-08-27

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Objective To analyze the clinical features of children with acute toxicity in Pediatric Intensive Care Unit (PICU), in order to provide evidence for the effective prevention and treatment. Methods A retrospective analysis was performed on the clinical data of 105 children,who were diagnosed with poisoning and discharged from PICU of Xijing Hospital from January 2007 to December 2016. Results Of the 105 cases, 67(63.8%) children were under 6 years old; 77 cases (77.3%) were from rural areas; 89(84.8%) cases were due to accidental poisoning. The drug poisoning accounted for 34 cases (32.4%). The pesticide, carbon monoxide (CO) poisoning and food poisoning accounted for 25 (23.8%), 19 (18.1%), and 11 (10.5%) respectively. Drugs were the most common toxins for urban children(42.9%), pesticide poisoning accounted for the highest proportion for rural children (32.5%). The intentional poisonings mainly happened in children at school age and adolescents. Drug and carbon monoxide poisonings presented with main clinical symptoms of the nervous system while pesticides and food poisonings showed mainly with symptoms of the digestive system, and rodenticide poisoning showed mainly with symptoms of hematological system. The effective rate of therapy was 92.4%, 4 cases (3.8%) were not improved and 4 were dead (3.8%). Conclusions Acute poisoning is common in infants and preschool children. The majority of acute poisoning is unintentional and most patients live in rural areas. Drugs are the most common agent causing the poisoning. There were differences in clinical manifestations among children suffering from different poisonings. Severe poisoning or delayed treatment is associated with poor outcome.

Survey on exposure to electronic devices of preschool children in Tongling city

FANG Hong-ying, TANG Yin-xia, XU Cheng-heng,YANG Fei-fei,ChEN Shang-hui

2018, 26(8):  913-915.  DOI: 10.11852/zgetbjzz2018-26-08-28

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Objective To understand the current situation and possible influencing factors of exposure to electronic devices in preschool children in Tongling city, in order to provide scientific basis for the rational use of electronic devices. Methods A total of 1 914 preschool children from 10 kindergartens in Tongling city were retrospectively investigated by a random cluster sampling method in December 2017.Demographic information, birth history, family status, exposure duration to electronic products, parental attitudes and more were collected.Data were analyzed by the χ² test and Logistic regression model. Results Totally 1 817 valid questionnaires were obtained, of which 981 were boys and 836 were girls.Television (91.7%) was the most common type of preschool children′s electronic devices.81.3% of children used more than two types of electronic devices.The order of using electronic devices was as following:watching animation (86.3%), listening to songs or stories (54.8%), playing games (33.9%) and using learning software (16.8%).Playing games were more common in boys, and listening to songs or stories were more common in girls (P<0.05).Listening to songs or stories, playing games and using learning software among different age groups were significantly different (P<0.05).Logistic regression analysis showed that the risk factors of exposure to electronic devices more than 2 hours in different periods were mother′s literacy level, twins, elder caregivers and father drinking. Conclusions Electronic devices exposure in preschool children in Tongling city is quite prevalent.So participation of the whole society, cooperation between medical staff and educators, and supervision by parents are necessary.Also, factors on gender, age, mother′s literacy level and main caregivers should be considered when relevant intervention methods are made.

Analysis of current status and influential factors on toothache among children in Foshan city

GUAN Qi-hua, MO Ying-ying, LIANG Zi-mian

2018, 26(8):  916-920.  DOI: 10.11852/zgetbjzz2018-26-08-29

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Objective To investigate current status and influential factors on toothache among children in Foshan city, in order to provide scientific basis for prevention and control of dental caries in children. Methods Six schools were randomly selected using random sampling method in urban elementary school from May to September in 2016, and students in the second grade and their parents were enrolled as participants with cluster sampling method.Questionnaires were filled out to collect students′ demographic information, oral health behavior, oral disease information and oral health knowledge.Single factor and multi-factor analysis method were used to analyze the influential factors for dental caries. Results Of the 2 241 people surveyed, 42.93% (962/2 241) had toothache or dental discomfort sense; Multi-factor Logistic regression analysis showed that the brushing teeth after eating sweets before sleeping (OR=5.420, 95%CI:3.630~8.093) and parental educational level under senior high school (OR=1.710, 95%CI:1.421~2.057) were risk factors for toothache.Brushing teeth twice a day (OR=0.484, 95%CI:0.345~0.680), brushing teeth with the help of parents (OR=0.537, 95%CI=0.386~0.756) and parents with high level of oral hygiene knowledge (OR=0.756, 95%CI=0.616~0.927) can reduce the risk of toothache.Parents′ knowledge of oral hygiene was mainly obtained through traditional media, and the percentage of obtaining knowledge from school health education and health professional departments were 26.15% and 20.57%, respectively. Conclusion Strengthening healthy education of school linkage, improving oral health knowledge of children and their parents are important measures to help develop good oral hygiene and reduce toothache or dental discomfort sense.

Investigation of environmental sample virus contamination in the norovirus epidemic

CHEN Tian-lin,DENG Xian-qun

2018, 26(8):  921-923.  DOI: 10.11852/zgetbjzz2018-26-08-30

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Objective To monitor virus pollution of environmental samples of 2 kindergartens where norovirus outbreaks occurred in Jingmen city,in order to provide evidence for the early disinfection and health management in the early stage of norovirus epidemic. Method According to real time PCR (RT-PCR) method published by the Chinese Center for Disease Control and Prevention (2015 Edition), norovirus nucleic acid in biological samples of kindergarten patients, food, water, tableware, sanitary products, toys, mop, door curtain, water stopcocks and other environmental samples were collected and tested. Results The positive rate of norovirus were 63.64% (7/11) in stockings with soap bags;50.00%(5/10)in mop; 44.44%(4/9)in cups;40.00%(2/5)in door curtain; 22.22%(2/9)in toys; 16.67%(1/6)in water stopcocks;11.11% (1/9) in tableware; 8.33%(1/12)in food;0.00% (0/6) in doorknob and drinking water. Conclusions Stockings with soap bags,mop, cups, door curtain and other environmental samples are prone to be contaminated by norovirus when norovirus epidemic occurs in kindergartens.It is suggested to focus on these areas and make reasonable disinfection measures,in order to prevent further spread and outbreak of norovirus.

Effects of adjustable weighted clothing on upper limb function and activity of daily living in children with cerebral palsy

XU Lei, KANG Bei-bei, TAN Li-ping, ZHU Lin, XIE Qiu-xue, YANG Ya-nan, JIANG Zhi-mei

2018, 26(8):  924-926.  DOI: 10.11852/zgetbjzz2018-26-08-31

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Objective To analyze the effect of adjustable weighted clothing on upper limb function and activity of daily living in children with cerebral palsy. Methods A total of 30 children with involuntary exercise-induced cerebral palsy admitted in the Third Affiliated Hospital of Jiamusi University from March 2016 to October 2016 were randomly divided into observation group (n=15) and control group (n=15).The control group was treated with routine rehabilitation training.while The observation group wore adjustable weighted clothes based on conventional rehabilitation.Upper limb function and the ability of activity of daily living of two groups before and after treatment were assessed by quality of upper extremity skills test (QUEST) and pediatric evaluation of disability inventory (PEDI) were compared. Result After treatment, the QUEST and PEDI scores of both groups were significantly improved than those before treatment, while the score of the observation group was significantly higher than that of the control group (all P<0.05). Conclusion Adjustable weighted clothing can effectively improve the upper limb function and daily living activities in children with involuntary exercise-induced cerebral palsy, so it is worth promoting in clinic.