Table of Content

10 November 2018, Volume 26 Issue 11

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Early diagnosis and intervention of Prader-Willi syndrome

LUO Xiao-ping, JIN Sheng-juan

2018, 26(11):  1161-1163.  DOI: 10.11852/zgetbjzz2018-26-11-01

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Prader-Willi syndrome (PWS) is a genomic imprinting defective disorder associated with chromosome 15q11-q3 region. Morbid obesity and its complications, as well as prominent cognitive and behavioral problems have brought huge medical and economic burden to PWS patients, their family and the society. PWS has been recognized in the neonatal period by severe hypotonia and feeding difficulties. In recent years, rapid developments in molecular genetics provide technological support for the diagnosis and genetic typing of PWS. Early diagnosis and management can largely improve the long-term outcome for patients with PWS.

Analysis of gene polymorphism in newborns with glucose-6-phosphate dehydrogenase deficiency in Liuzhou, Guangxi

TAN Jian-qiang, HUANG Jun, PAN Li-zhen, YANG Jin-ling, CHANG Rong-ni, LI Zhe-tao, YAN Ti-zhen,CAI Ren

2018, 26(11):  1164-1167.  DOI: 10.11852/zgetbjzz2018-26-11-02

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Objective To explore incidence gene types of glucose-6-phosphate dehydrogenase deficiency,and provide the support for genetic counseling and clinical medication.Methods We found 81 112 neonates who were newborn screened by glucose 6 phosphate dehydrogenase quantitative testing during the period from June 2016 to December 2017 in Liu zhou Maternal and Child Health Hospital,329 blood samples were collected from 2 595 suspected patients,and 50 blood samples of female neonates who were newborn screened by glucose 6 phosphate dehydrogenase quantitative testing were normal. G6PD gene were analyzed by multiplex probe melting curve to detect the 12 types common G6PD gene mutations.Results There were 301 cases detected gene mutation in 329 cases (236 male, 93 female) of samples. Multiplex probe melting curve has detected 28 wild type samples(9 male, 19 female),227 male hemizygous mutation samples,7 female homozygous mutation samples,20 female compound heterozygous mutation samples and 47 female heterozygous mutation samples. Find 10 different mutation types:71 cases of 95A>G(23.6%),1 cases of 392G>T(0.33%),1 cases of 517T>C(0.33%),1 cases of 592C>T(0.33%),12 cases of 871G>A(3.99%),3 cases of 1004C>A(0.99%),31 cases of 1024C>T(10.3%),1 cases of 1360C>T(0.33%),69 cases of 1376G>T(22.9%),111 cases of 1388G>A(36.9%),383T>C and 487G>A mutations were not detected. 4 female heterozygous mutation samples were detected form 50 female neonates.Conclusion 1388G>A、95A>G and 1376G>T are the most common types of G6PD gene mutation in Guangxi Liuzhou, multiplex probe melting curve analysis for G6PD gene mutation is sensitive for diagnosis female heterozygous mutation.

Analysis of the deafness-related gene screening results of 33 321 newborns

XU Wen-hua, ZHANG Zhi-cheng ,MEI Jin-xin , GENG Xiao-fang

2018, 26(11):  1168-1171.  DOI: 10.11852/zgetbjzz2018-26-11-03

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Objective To explore the significance of newborn screening for mutations of deafness-related genes, in order to provide ear and hearing care guidance to parents.Methods With the informed consent of the parturient and her family, totally 33 321 cases of neonatal heel blood were collected from August 2014 to February 2018, matrix assisted laser desorption ionization time-of-flight mass spectrometry was used to detect 20 mutation sites of 4 deafness-related genes.Results Among 33 321 neonates, 1 693(5.08%) neonates were positive. The number of neonates carrying heterozygous mutations in GJB2, SLC26A4, and GJB3 were 893, 546 and 123, respectively. And the corresponding carrier rates were 2.68%, 1.64% and 0.37%, respectively. The number of neonates carrying homogeneous or heterogeneous mutation in mitochondrial 12S rRNA gene was 96 with a carrier rate of 0.29%. In addition, 8 cases of homozygous or complex heterozygous mutations in GJB2 gene and 2 cases of homozygous or complex heterozygous mutations in SLC26A4 gene were identified. There were also 25 cases of double heterozygous mutations.Conclusion Deafness-related gene screening in newborn is crucial for early detection, diagnosis and intervention in children with hearing impairment.

Evaluation of the performance of genetic screening processor in screening for congenital adrenal hyperplasia in newborns

WAN Zhi-hui, HU Jin-chun, JIAN Yong-jian, LIU Wei, MA Zhi-jun

2018, 26(11):  1172-1175.  DOI: 10.11852/zgetbjzz2018-26-11-04

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Objectives To evaluate the feasibility of genetic screening processor (GSP) equipment applied in the screening for congenital adrenal hyperplasia (CAH) in newborns by detecting 17-OH-progesterone (17-OHP) in blood, and to analyze the consistency between GSP and AutoDELFIA 1235 method.Methods 1) The performance of GSP applied in CAH screening was evaluated through calculating the inaccuracy, precision and linearity of GSP in detecting 17-OHP of dried blood spots specimens from American centers for disease control and prevention(CDC)and the quality control in the reagent kit. 2) A total of 2288 samples (2180 unknown and 108 AutoDELFIA 1235 positive samples) were detected by GSP and AutoDELFIA 1235, and the consistency between GSP and AutoDELFIA 1235 as well as clinical diagnosis was analyzed.3) The initial cut off value was determined by percentile statistical analysis.Results 1) The average of within-run coefficient of variation (CV) and between-run CV were 3.35%~5.35% and 3.07%~6.21%, respectively. The precision and linearity of GSP detection were fine. 2) The positive, negative and total consistency of GSP and AutoDELFIA 1235 were 59.7%, 99.8% and 97.7% respectively.The sensitivity and specificity of GSP were 100% and 96.93%, respectively. 3) It is recommended to use 12 nmol/L as cutoff value.Conclusions 1) GSP equipment and kits are suitable for implementation and have acceptable performance for NBS of CAH. 2) GSP method has advantages compared with AutoDELFIA 1235, such as higher specificity. GSP methodology tends to underestimate 17-OHP concentration when compared with AutoDELFIA assay, so more clinical studies are warranted to reevaluate cutoff value.

Development of conceptual model of asthma patient reported outcomes reported by parents and exploration of the scale′s construction

XU Tong, JIANG Xun, WANG Ning, ZHANG Hao, WU Hai-jun, YUAN Jing, SHANG Lei

2018, 26(11):  1176-1179.  DOI: 10.11852/zgetbjzz2018-26-11-05

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Objectives To develop a conceptual model for childhood asthma patient reported outcomes reported by parents, and to explore the structure of patient reported outcomes scale preliminarily, in order to provide basis for the compilation and evaluation of the scale.Methods A conceptual model, initial dimensions and items pool were developed by literature review combined with expert consultation and target group interview methods. The items were preliminarily screened and revised according to the test results of 30 parents of asthmatic children and the evaluation opinions of 5 experts, and then an initial questionnaire containing 72 items was formed. Totally 212 parents of asthmatic children were investigated, and the items of initial questionnaire were screened by using the classical test theory methods, combined with parallel analysis, exploratory factor analysis methods and expert advice, finally the structure of childhood asthma patient reported outcomes scale reported by parents was identified.Results A four primary indicators and eight secondary indicators conceptual model was constructed. Based on that, an initial questionnaire containing 72 items was compiled and a field investigation was carried out. The items screening, parallel analysis and exploratory factor analysis showed that five common factors were extracted, and the cumulative variance contribution rate was 51.6%. The five common factors reflected children′s physical condition, psychological status, daily activities, behavior restrictions and family influence.Conclusions The extracted five common factors were covered in the conceptual model and could explain the impact of asthma on children. The scale of childhood asthma patient reports outcomes reported by parents should be compiled in 5 dimensions, including physical condition, psychological state, daily activities, behavior restrictions and family influence.

Study on the predictive validity of the general movements assessment in fidgety period for motor development outcome in small for gestational age infants

WANG Jun, HE Min-si, YANG Hong, SHI Wei, WANG Su-juan, SHI Xiao-juan,ZHU Xiao-yun, CAO Jia-yan, GAO He-rong

2018, 26(11):  1180-1184.  DOI: 10.11852/zgetbjzz2018-26-11-06

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Objective To explore the predictive validity of the general movements assessment (GMA) in fidgety period for motor development outcome in small for gestational age (SGA) infants, in order to provide evidence for early rehabilitation intervention.Methods A total of 61 SGA infants were retrospectively analyzed in Department of Rehabilitation of Children's Hospital of Fudan University. The motor development outcomes after 12 months were obtained by searching the database of the pediatric diagnosis and treatment application system in the department or by telephone and WeChat. The sensitivity, specificity, positive predictive value and negative predictive value of GMA for motor development outcome (cerebral palsy and motor development delay) were analyzed.Results Among 61 GMA results, 18 GMA results were identified as fidgety movement absent (F-) and 47 GMA results as normal fidgety movement (NF). In the follow-up of motor development, 7 cases were clinically diagnosed with cerebral palsy and 11 cases with motor development delay, while 43 cases had normal motor development. The sensitivity, specificity, positive predictive value and negative predictive value of GMA for cerebral palsy were 100%, 97.67%, 87.5% and 100%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of GMA for motor development outcome (cerebral palsy and motor development delay) were 94.44%, 97.67%, 94.44% and 97.67%, respectively.Conclusion The GMA in fidgety period has a good predictive validity for the abnormal motor developmental outcomes, especially for cerebral palsy. As a new non-invasive and unobtrusive assessment tool, GMA can be widely used in the follow-up work of brain development in SGA infants.

Study on the associations between family socioeconomic status and attention deficit hyperactivity disorder symptoms in preschoolers

YAN Qiong, TONG Lian

2018, 26(11):  1185-1188.  DOI: 10.11852/zgetbjzz2018-26-11-07

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Objective To know about the prevalence of attention deficit hyperactivity disorder(ADHD) in preschoolers, and to analyze the association between family socioeconomic status and ADHD symptoms in preschoolers.Methods A total of 1 142 children aged 4~7 and their parents were recruited from 7 kindergartens in rural and urban areas by convenient cluster sampling. ADHD symptoms were assessed by ADHD Rating Scale Ⅳ-Preschool Version, and parents were requested to fill out the questionnaire. Univariate and multivariate Logistic regression analysis was applied to analyze the data.Results The overall prevalence of ADHD in preschoolers was 7.01%, and 7.38% for boys, 6.56% for girls. The prevalence of ADHD in rural areas was 7.99%, while 6.67% in urban areas. Multivariate Logistic regression showed that girls and children whose father was older and with more book tended to have fewer ADHD symptoms. In addition, children with higher annual living cost after three years old showed more ADHD symptoms in preschool period. However, the association was only obvious in children from urban areas, and children in rural areas showed opposite results.Conclusions Family socioeconomic status, especially the living cost for children, have a significant association with ADHD symptoms in preschoolers. Furthermore, the differences on economic disparities between urban and rural areas and among children at different age stages, play an important mediating effect on the association between family socioeconomic status and ADHD symptoms.

Effect of colostrum as oral immune therapy on clinical outcomes in very low birth weight preterm infants

ZHOU Qin, TAO Ya-qin, LI Ping, YIN Juan, CAI Wei, YANG Ying, WU Xiao-qin, YU Ren-qiang

2018, 26(11):  1189-1193.  DOI: 10.11852/zgetbjzz2018-26-11-08

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Objective To assess the effect of colostrum as oral immune therapy on clinical outcomes in very low birth weight preterm infants, in order to provide evidence for the treatment of preterm infants.Methods Totally 89 preterm infants with very low birth weight in the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from January 2015 to December 2016 were enrolled in this study, and were divided into oral immune therapy group(n=59) and control group(n=30). Participants received colostrums or normal saline via oropharyngeal route for 3 days. Clinical data during hospitalization and prognostic indicators were collected and analyzed.Results The incidence of clinical sepsis was 8.5% in the oral immune therapy group, significantly lower than that in control group (26.7%)(P＜0.05). However, there were no significant differences on the incidence rates of proven sepsis, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), periventricular-intraventricular hemorrhage (PIVH) and bronchopulmonary dysplasia (BPD), hospitalization days, body weight at discharge and clinical prognosis(all P＞0.05).Conclusion Colostrum as oral immune therapy can reduce the incidence of clinical sepsis, but not reduce the incidence rates of proven sepsis, NEC, ROP, PIVH and BPD.

Effects of ethyl pyruvate on expression of aquaporin-4 and ultrastructure changes in neonatal rats with brain damage caused by intrauterine infection

SONG Fu-xiang, KONG Xiang-ying, PANG Wei, TAN Li-ping, GUO Jin

2018, 26(11):  1194-1198.  DOI: 10.11852/zgetbjzz2018-26-11-09

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Objective To study the effect of ethyl pyruvate (EP) in the expression of aquaporin-4(AQP4) and ultrastructure changes in neonatal rats with brain damage caused by intrauterine infection.Methods A total of 36 pregnant Wistar rats were enrolled in this study, and were divided into lipopolysaccharide (LPS) group, EP group and normal saline(NS) group, with 12 rats in each group. LPS group was consecutively injected with LPS (380 μg/(kg·d) intraperitoneally, EP group were consecutively injected with lipopolysaccharide intraperitoneally, and EP was administrated intraperitoneally at a dose of 40 mg/kg immediately. NS group was injected with normal saline intraperitoneally as control group. After the delivery of pups, thirty-six pups were selected. Placenta of rats were taken for hematoxylline-eosin (HE) staining to confirm its intrauterine infection in 12 hours, 24 hours,48 hours after birth. Aquaporin-4 expression in brain tissue was studied through immunohistochemical analysis. Ultrastructure changes in damaged brain and control group were studied electron-microscopically.Results Obvious pathological changes were observed in the placenta of LPS group. The expression level of AQP4 was lower in EP group and NS group in 24 hours and 48 hours after birth than that in LPS group (P<0.05). LPS group nerve cells ultrastructure showed serious injury.Conclusion Ethyl pyruvate has neuro-protective effect on LPS-induced brain injury, and may be associated with the expression level of AQP4.

Research progress on the influencing factors and related pathogenesis mechanism of neural tube defects

JIANG Chun-qian, LI Yan-ping, GUO Shuang, SONG Ying-dong, XU Ding

2018, 26(11):  1199-1202.  DOI: 10.11852/zgetbjzz2018-26-11-10

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Neural tube defects (NTDs) are severe congenital malformations that originated in the process of embryogenesis, and are the result of an abnormal process of neural tube closure. NTDs are caused by multiple factors, including genetic factors, environmental factors, and the interaction between genetics and the environment. Folic acid supplementation may reduce the incidence, but the mechanism is not yet clear, and the occurrence of NTDs is also related to other factors. This review summarizes research progress on the factors associated with NTDs and the related pathogenesis mechanism.

Nutrition management of small for gestational age

LIN Rong, WU Ming-yuan

2018, 26(11):  1203-1206.  DOI: 10.11852/zgetbjzz2018-26-11-11

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Small for gestational age (SGA) is one of the most important causes for the morbidity and mortality of perinatal infants. Early nutrition is an important determinant of growth, morbidity and psychomotor development in SGA. Aggressive nutrition helps improve postnatal growth retardation, decreases morbidity and is positively related to psychomotor development. There is a consistent association between rapid infancy growth and metabolic syndrome in childhood and later life. So, to balance the benefits and disadvantages of rapid early growth is critically challenging. This review summarizes the optimal nutrition management for SGA newborns, in order to provide evidence for facilitating the quality of nutritional management for SGA,thereby improving the prognosis of SGA.

Progress on influencing factors for wheezing diseases among children

FU Xia-lin, GONG Xiao-hui, TAN Ju-xiang, YAN Mei-ling

2018, 26(11):  1207-1210.  DOI: 10.11852/zgetbjzz2018-26-11-12

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Wheezing diseases among children are widely seen throughout the world and are more prevalent in recent years. Researchers both at home and abroad are gradually focusing on influencing factors for wheezing diseases among children, which not only have in common, but also are different in terms of climate, environmental factors and customs in various regions. Therefore, this review summarizes the research progress on influencing factors for wheezing diseases among children, thus offering theoretical basis for the prevention and control of wheezing diseases among children.

Research progress on the correlation between childhood obesity and asthma

LIU Yan-dong, QU Shu-qiang

2018, 26(11):  1211-1213.  DOI: 10.11852/zgetbjzz2018-26-11-13

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With the development of society and improvement of living standards, obesity has become a hot topic in the international arena. The International Task Force on Obesity points out that “obesity will become the greatest enemy of human health and life satisfaction in the 21st century” as a national backup for development. Childhood overweight and obesity not only lead to diesase in adults, but also increase the risk of asthma. Recent studies showed obesity and asthma interacted with each other in the development of the disease, and there is also a parallel relationship between the prevalence of obesity and asthma.Obesity asthma is the most unique asthma phenotype, but its specific pathogenesis is not clear yet. This review describes possible pathogenesis mechanism of obesity asthma from chronic inflammatory injury, insulin resistance, metabolic syndrome, dysbacteriosis, vitamin D deficiency and genetic genes, in order to provide reference for clinical practice.

Research progress on the immunity in mycoplasma pneumoniae infection of children

YU Jing, ZHANG Hui

2018, 26(11):  1214-1216.  DOI: 10.11852/zgetbjzz2018-26-11-14

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Mycoplasma pneumonia (MP) infection is a common infectious disease in children, which can be transmitted through droplets of trachea, pharynx, nasal secretions and sputum. The disease has seasonal and regional characteristics, and the duration varies. At present, the immunological mechanism of MP infection in children is the focus and hotspot of researchers. This review summarizes research progress on the immune mechanism of MP children, in order to provide basis for the diagnosis and treatment of MP infection in children.

Meta-analysis of the influencing factors for birth defects in China from 2008 to 2018

CAO Li-li, WAN Li, QIAN Ting

2018, 26(11):  1217-1220.  DOI: 10.11852/zgetbjzz2018-26-11-15

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Objective To explore the main risk factors related to birth defects, in order to provide scientific evidence for preventing birth defects.Methods Meta-analysis was performed to quantitatively review case-control studies of risk factors for the birth defects since 2008 to 2018.Results Multi-factor analysis combined with effect quantity estimation results showed that family history, mother′s smoking, father′s smoking, exposure to teratogenic factors during pregnancy, environmental pollution sources, adverse pregnancy and childbirth history, early pregnancy illness, mood disorders, and drug use were risk factors. While premarital examination, pregnancy examination, folic acid supplementation, and regular intake of high quality protein during pregnancy were protective factors.Conclusions Pregnant women are suggested to avoid prenatal exposure to various physical and chemical harmful substances, attach importance to routine marriage and pregnancy tests, and establish a healthy lifestyle. Also, more high quality protein and folic acid supplementation during pregnancy is crucial to improve physical fieness.

Treatment and follow-up results of neonatal diseases screening in Shaanxi province from 2010 to 2016

LIU Hong-li,LI Feng-xia

2018, 26(11):  1221-1223.  DOI: 10.11852/zgetbjzz2018-26-11-16

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Objective To summarize and analyze the screening results, treatment and follow-up of hyperhenylalaninemia (HPA) and congenital hypothyroidism (CH) in neonatal screening center of Shaanxi province from 2010 to 2016.Methods Newborn fetus heel blood was collected 72 hours after birth, and dried blood filter paper was made. The levels of phenylalanine (Phe) and thyrotropin (TSH) were tested, and patients with positive results of Phe ≥2.0 mg/dl、TSH ≥10 μU/ml were recalled for diagnosis. The blood levels of Phe and Tyr were detected by tandem mass spectrometry (MS/MS), and thyroid function (TSH,T₃,T₄, FT₃, FT₄) was detected and analyzed by chemiluminescence immunoassay, so that the diagnosed was made.Results The number of live births in the province′s midwifery institutions was 2 751 268 cases from 2010 to 2016, 2 329 335 (84.67%) cases were screened. Totally 131(1/17 781), 300 (1/7 764), 966 (1/2 411) cases were diagnosed with mild HPA, phenylketonuria (PKU) and CH, respectively. Medical records were established after the diagnosis, and participants were given low-phenylalanine diet and oral levothyroxine tablets (L-T₄) alternative treatment. Gesell Developmental Scale assessment results indicated that PKU children who started treatment within 6 months of age had significantly higher intelligence quotient (IQ) than those who started treatment after 6 months of age (P<0.01). Follow-up monitoring indicated that there was no significant difference on IQ between CH children and normal children after sustained treatment (P>0.05).Conclusion Comprehensive screening of neonatal diseases, increasing screening coverage, standardization of treatment and long-term follow-up monitoring as soon as possible can prevent PKU and CH children from irreversible impairment of physical and mental status, which is of great significance in improving their prognosis and quality of life.

Epidemiological characteristics of congenital renal malformations cases in Pingyin county, Shandong province, China from 2004 to 2017

TI Xin-jing, ZHANG Long-fei, ZHANG Shu-xia, YU Zhi-xia, WANG Zhi-ping

2018, 26(11):  1224-1227.  DOI: 10.11852/zgetbjzz2018-26-11-17

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Objective To analyze the characteristics of congenital renal malformations(CRMs) cases in Pingyin county by descriptive epidemiology, in order to provide scientific basis for prevention and control of CRMs.Methods The CRMs cases and newborns were collected by birth defects registration data in Pingyin county from 2004 to 2017, and the general characteristics of 83 cases were summarized. The incidence(1/10⁴) was calculated and the difference on CRMs incidence between gender and district area were analyzed. All cases were mapped. The characteristics, diagnostic method and outcome of CRMs were described.Results 1)Incidence of CRMs:There were 83 cases (17.06/10⁴) of CRMs inPingyin county from 2004 to 2017.The difference on the incidence of CRMs between males and females was not statistically significant(P＞0.05),while this difference was significant between urban and rural children(P＜0.05).Renal malformation(4.93/10⁴),congenital hydronephrosis(4.52/10⁴) and renal agenesis(3.50/10⁴) were ranked the top three of CRMs. 2) Epidemiological distribution:Most CRMs cases distributed in the northwestern and southeastern plain area of Pingyin county. The occurrence of hydronephrosis and renal malformation mainly occurred around 2007, and significantly increased in 2016.Also, hydronephrosis mainly appeared in male and most renal agenesis appeard in famale(both P＜0.05).3) Clinical features and diagnosis:The proportion of diagnosis in prenatal 28 weeks of CRMs was 27.71%, and 97.59% of cases were diagnosed by ultrasonography. The proportion of bilateral renal defects was high(39.76%),and most are single malformations(83.13%).The proportions of live births and stillborn baby were 50.60% and 49.40%,respectively.Conclusions The incidence of CRMs in Pingyin county was obviously high compared with other regions in China, and regional, temporal and gender clustering is also found, indicating there may be regional risk factors. It is suggested that prenatal diagnosis competence should be strengthened in order to improve the early detection rate of CRMs in Pingyin county.

Research on the association of interleukin-6 and interleukin-1β gene polymorphism with severity of hand foot and mouth disease induced by enterovirus 71

LI Mei, LI Ya-ping, DENG Hui-ling, ZHANG Wen, MA Le, WANG Li-qun, WU Yuan

2018, 26(11):  1228-1232.  DOI: 10.11852/zgetbjzz2018-26-11-18

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Objective To investigate the association of inflammatory cytokines including interleukin-6 (IL-6), IL-6R, IL-1β and IL-1RN gene polymorphism with severity of hand foot and mouth disease (HFMD) induced by enterovirus 71 (EV71), in order to provide evidence for early recognition and assessment of severe HFMD.Methods A total of 180 EV71 HFMD cases including 108 severe cases and 72 mild cases from the Second Affiliated Hospital of Xi′an Jiaotong University and Xi′an Children′s Hospital were randomly enrolled in this study. All participants were genotyped for the most common IL-6, IL-6R, IL-1β and IL-1RN single-nucleotide polymorphisms (SNPs) using the SNPscan multiple SNP typing method. The gene type of rs1800796, rs2069837 of IL-6, rs2228145, rs4845617 of IL-6R,rs16944, rs1143627 of IL-1β and rs315952, rs9005 of IL-1R among 180 cases were detected by SNPscan kit.Results The severity risk was significantly increased in IL-6 rs1800796 allele G(OR=1.312, 95% CI:1.041~1.653)and IL6-R rs2228145 allele C (OR=1.330, 95% CI:1.064～1.663), while it was reduced in IL-1β rs1143627 allele G (OR=0.790,95% CI:0.635~0.981). No association of gene polymorphism with severity of EV71 HFMD was observed in IL-6 rs2069837, IL-6R rs4845617, IL-1β rs16944, IL-1RN rs315952 and IL-1RN rs9005.Conclusion The gene polymorphism of IL-6 rs1800796, IL-6R rs2228145 and IL-1β rs1143627 were associated with severity of EV71 HFMD.

Prevalence and genotypes of the glucose-6-phosphate dehydrogenase deficiency in neonates from Qingdao

WANG Hong-qin,WEI Ming,LI Wen-jie

2018, 26(11):  1233-1235.  DOI: 10.11852/zgetbjzz2018-26-11-19

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Objective To investigate the prevalence and genotypes of the glucose-6-phosphate dehydrogenase(G6PD)deficiency in neonates from Qingdao.Methods A total of 214 466 local neonates in Qinagdao from January 2014 to February 2016 were screened for G6PD deficiency by fluorometric method.Then all the screening positive samples were subjected to genotype by fluorescent PCR melting curve analysis.Results Totally 44 positive samples were screened and 36 samples were determined by gene diagnosis. The prevalence of G6PD deficiency in neonates from Qingdao was 0.168‰.(36/214 466),and the prevalence of males and females was 0.149‰ (32/214 466) and 0.0187‰(4/214 466),respectively. Finally seven G6PD gene mutations were detected, including c.1376 G＞T(13/36,36.11%), c.1388 G＞A(10/36,27.78%), c.95 A＞G(7/36,19.44%), c.487 G＞A(2/36,5.56%), c.871 G＞A(2/36,5.56%),c.517 T＞C(1/36,2.78%) and c.383 T＞C(1/36,2.78%).Conclusion The prevalence of G6PD deficiency in Qingdao is lower,and the most common genotypes are c.1376 G＞T, c.1388 G＞A and c.95 A＞G, accounting for 83.33% of the gene mutation cases.

Baseline survey on capacity of child health service in prefecture-level maternal and child health institutions in China

YANG Jin-liuxing, HE Zhi-min, NIE Yan, MA Zhong-hua, XUE Yan-ping, WANG Yan, ZHANG Yue, XU Tao


2018, 26(11):  1236-1239.  DOI: 10.11852/zgetbjzz2018-26-11-20

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Objective To investigate the status of child health care personnel and facility resources, situation of child health service and management in prefecture-level maternal and child health (MCH) institutions in China, in order to provide baseline data for the comparison of development of child health care.Methods Data of a historical survey in 2013 were analyzed. In this survey, one third of prefectures and municipalities were selected by using the probability proportion size method from 13 nationally representative provinces from May to July in 2013, and the situation of child health service in prefecture-level MCH institutions in China were investigated by questionnaire survey.Results In whole 51 prefecture-level MCH institutions, there were 1.64 staff members in MCH institutions providing services for every ten thousand children on average. Each institution carried out nine items of children health service. The setting rate of the growth and development service was the highest (98.0%). Then the setting rates of nutrition consultation service, hearing service, psychological behavioral test service were 94.1%, 92.2% and 90.2%, respectively. Among all the services, the setting rate of child rehabilitation service was the lowest (62.7%). Each institution had 6 children health clinics averagely. More than 70% of institutions had growth and development clinic, psychological behavioral test clinic, eye care clinic and hearing care clinic, however, the setting rate of high-risk infants follow-up clinic, dental clinic, child rehabilitation clinic and early child development clinic were all lower than 60%. Each institution had organized four training courses for subordinate health care institutions and three training courses for health care staffs from childcare institutions in 2012.Conclusions The area differences on capacity of child health service are contractible. However, the personnel and facility resources are inadequate and the setting rate of child health clinic should be increased and more relevant service should be provided.

Application of gray model (1,1) in predicting death from accidental injury

XIANG Xiao-mei, ZHANG Li, YANG Wu-yue, LIU Ji-feng

2018, 26(11):  1240-1243.  DOI: 10.11852/zgetbjzz2018-26-11-21

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Objective To predict the accidental injury death rate of children under 5 years old in Xi′an according to the data from 2006 to 2015 using gray model(1,1) , in order to provide theoretical basis for the corresponding countermeasures. Method The general accidental death situation of children in Xi′an was described, and the gray model(1,1) was used to predict accidental injury death rate.Results There were more accidental injury death cases of urban children.Accidental asphyxia, traffic accidents were the first two causes.Gray model(1,1) results showed that the accidental injury death rate decreased year by year.The death of boys was more stable, while girls′ death rate decreased.The incidence of asphyxia increased and the incidence of traffic accident death was relatively stable.Conclusion In the next three years, the accidental injury death rate in Xi′an generally shows a decreasing trend.

Analysis of related factors of recurrent upper respiratory tract infection in children aged 3-6 years

CHEN Xiao-jun, GUO Rui-juan, ZENG Li-sen

2018, 26(11):  1244-1246.  DOI: 10.11852/zgetbjzz2018-26-11-22

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Objective To explore factors influencing the recurrent upper respiratory tract infection (RRTI) in children aged 3-6 years.Methods Totally 160 children aged 3-6 years with RRTI were selected as case group, and 160 healthy children at the same age were selected as control group. Children′s demographics data, parents′ data, children′s living environment, nutritional status and trace elements were collected. And the influencing factors of RRTI were analyzed by Logistic regression in 3 to 6-year-old children.Results 1) The levels of iron, calcium and zinc in children were significantly lower than those in control group (t =-4.31,-7.98,-7.53, all P <0.05);2)Logistic regression analysis showed that mothers′ education level above high school was the protective factor of RRTI in children (OR=0.279, P=0.024), parents with allergies history (OR=1.412, P=0.004), smoking of family members (OR=1.565, P=0.001), outdoor activities time < 2 h/d (OR=4.963, P=0.033), antimicrobial use≥ 3 times/year (OR=11.894, P＜0.001) were all significantly risk factors for RRTI in children.Conclusion Children lack of calcium, iron, zinc and other trace elements are prone to develop RRTI. Maternal education level above high school was the protective factor of RRTI in children. Avoiding second-hand smoking, decreasing the frequency of antimicrobial use and increasing the daily outdoor activities time can prevent the occurrence of RRTI.

Analysis of clinical feature of 30 neonates with fungal sepsis

CHEN Jing, FAN Jun-jie, ZHU Xue-ping

2018, 26(11):  1247-1250.  DOI: 10.11852/zgetbjzz2018-26-11-23

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Objective To analyze clinical feature of 30 neonates with fungal sepsis, in order to improve the level of diagnosis and treatment.Methods Totally 30 neonates with fungal sepsis and 78 premature infants with fungal sepsis were included in this study. Clinical manifestations, pathogens, laboratory findings and treatment outcomes were analyzed. The differences of laboratory parameters between fungal sepsis and bacterial sepsis were also analyzed.Results Of these cases, 25 cases(83.3%) were premature infants, and 28 cases(93.3%) had low birth weight. Risk factors included use of broad-spectrum antibiotics (29, 96.7%), tracheal intubation (18, 60.0%) and central vein catheterization (14, 46.7%). Clinical manifestations included fever, apnea and shortness of breath. Compared with premature bacterial sepsis cases, there were fewer cases with elevated procalcitonin (PCT) and more cases with thrombocytopenia in neonates with fungal sepsis (both P<0.01). G test showed that 8 out of 9 cases had positive results(88.9%). The pathogens were all Candida, including 19 strains of Candida albicans(63.3%) and 11 strains of non-Candida albicans(36.7%). For Candida albicans, all strains were susceptible to amphotericin, 14 strains were susceptible to fluconazole, while 3 strains were resistant to fluconazole and 2 strains were intermediate. All non-Candida albicans were susceptible to tested drugs. Totally 25 cases(83.3%) were cured after treatment.Conclusions The clinical manifestations of neonatal fungal sepsis were nonspecific. G test, PCT and platelet count were helpful for the diagnosis. Candida albicans were main pathogens in this study with some drug-resistant strains. Proper drug should be selected with the guidance of drug sensitive test.

Effect of different types of allergens on T lymphocyte subsets of children with asthma

XU Chang, LUO Li-yan, RAO Hua-ping

2018, 26(11):  1251-1253.  DOI: 10.11852/zgetbjzz2018-26-11-24

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Objective To analyze the effect of different types of allergens on T lymphocyte subsets of children with asthma.Methods Totally 147 cases of asthma children were collected to detect the allergens and flow cytometry was conducted to test immune indices levels, such as CD3, CD4, CD8, CD4/CD8.Results Children developed asthma at the age of one year and eleven months averagely. The proportion of male cases (72.1%) was higher than that of female cases (27.9%). Environmental allergy was found predominant in childhood with allergic asthma. The CD4 level of children with environmental allergy was significantly different from that without environmental allergy (χ²=10.317, P=0.006), while significant difference was not found in term of CD3, CD4, CD8, CD4/CD8 levels (P>0.05).Conclusion Environmental allergy is prone to influence children′s immune function, resulting in CD4 T lymphocyte out of balance. So it is supposed to pay more attention to environmental allergy in judging the immune function of asthma children and clinical prevention and treatment.

Analysis on newborn status of preterm infants in Beijing from 2011 to 2016

ZHAO Jin-qi, YANG Nan, GONG Li-fei, YANG Hai-he, KONG Yuan-yuan

2018, 26(11):  1254-1256.  DOI: 10.11852/zgetbjzz2018-26-11-25

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Objective To investigate the incidence and influencing factors of premature infants in Beijing, in order to provide evidence for health management of premature.Methods A retrospective analysis was carried out on 74 994 premature infants from all midwifery institution in 16 districts of Beijing from 2011 to 2016.Results The prevalence rate of the premature infants was 5.49% in neonates born in Beijing from 2011 to 2016, and gender composition ratio is 1.27∶1(boys:girls). Totally 14 146(18.9%) premature infants were born at gestational age under 34 weeks, and 60 848(81.1%) premature infants were born at gestational age more than 34 weeks. Multivariate analysis found that multiple births (OR=2.519, 95%CI:2.433~2.611), female neonates (OR=1.348, 95%CI:1.307~1.387), warm season (OR=1.055~1.074, 95%CI:1.012~1.119) and high-risk neonates (OR=47.619, 95%CI:43.478~50.000) were risk factors of low birth weight in premature infants.Conclusion The prevalence rate of premature infants in Beijing is lower than that in developed countries, but there is an increasing trend year by year. Factors influencing birth weight should be paid more attention to, so as to provide basis for reducing incidence of premature infants and improving the prognosis of premature infants.

Feasibility study on the application of swallowing function training and non-nutritive sucking in extremely premature infants

ZHANG Jin-jun, BIAN Shan-shan, XIAO Hai-yan, WANG Ying

2018, 26(11):  1257-1259.  DOI: 10.11852/zgetbjzz2018-26-11-26

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Objective To analyze the clinical value of swallowing function training and non-nutritive sucking treatment in extremely premature infants,in order to provide evidence for clinical intervention.Methods Totally 100 cases of extremely premature infants in Neonatal Intensive Care Unit (NICU) of Changzhou Maternal and Child Health Hospital were enrolled in this study from January 2016 to August 2017. According to the random non-blind method of grouping, infants were divided into two groups, with 50 cases in ead group. The control group took traditional oral feedings, while the intervention group received swallowing function training combined with non-nutritive sucking. The feeding situation, fasting time, oral gastric nutrition time, average hospitalization days and total enteral feeding for gestational age and other indicators of the two groups were analyzed and compared.Results The cases of good feeding performance in intervention group (46, 92.0%) were significantly more than those in control group (31, 62.0%)(P<0.05). The fasting time, the nutrition time of nasogastric tube, the average hospitalization day and the age of the full mouth feeding in intervention group were significantly shorter than those in control group(all P＜0.05).Conclusion Swallowing function training on extremely premature infants and non-nutritive sucking can help premature establish the swallowing sucking reflex, improve oral feeding conditions, and promote the rehabilitation so that it is worthy of popularization and application.

Influencing factors for the unintentional injuries in the nurseries and kindergartens of Aba Tibetan and Qiang Autonomous Prefecture

RAN Yu-chen,NIE Jing,LIAN Xiao-xia,ZUO Qing-hua, CAI Yuan-xing, WANG Hong

2018, 26(11):  1260-1263.  DOI: 10.11852/zgetbjzz2018-26-11-27

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Objective To investigate the current status and influencing factors of unintentional injuries in the nurseries and kindergartens of Aba Prefecture. Method Random cluster stratification sampling method was used to study the status of unintentional injuries among 4 368 preschool children in 8 areas of Aba Prefecture from April to June in 2015.Results The overall prevalence rate of unintentional injure was 15.04％.The composition of children′s unintentional injuries type was different among different nations(P=0.035).Single factor analysis showed that factors including urban and rural, areas, nations, sex, maternal education level, family income level, main foster ages and parents′ knowledge level on unintentional injuries affected the incidence of unintentional injuries rate in children(P＜0.05).Logistic regression analysis showed that different areas, mothers education level and family income level were factors influencing the occurrence of unintentional injuries.The prevalence of unintentional injuries in children with higher maternal educational level and family economic level were lower.Conclusions The unintentional injuries are relatively serious in Aba Prefecture.The prevalence rate of unintentional injuries is related to maternal education and family economic level.

Study on the caries prevalence among 5 586 children aged 3-6 in Haidian district of Beijing

LIN Xiao-hua, MIAO Jiang-xia,GAO Su-hong

2018, 26(11):  1264-1266.  DOI: 10.11852/zgetbjzz2018-26-11-28

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Objective To investigate the status of primary teeth caries prevalence among 3 to 6-year-old kindergarten children in Haidian district of Beijing, in order to provide epidemiological basis for prevention and control of teeth caries in children.Method Totally 5 586 children aged 3~6 from 16 kindergartens in Haidian district of Beijing were investigated for oral health status from March to April in 2015 and the results were statistically analyzed.Results The caries prevalence of children in this study was 64.43%.The caries prevalence increased with the increasing age of children (χ²=133.549, P<0.001).The caries dmft value was 3.70±4.10.The differences on caries dmft among children at different age groups were statistically significant (F= 61.323, P<0.001).The affected teeth were mainly located in anterior teeth in younger children, while molars were more easily affected in older children.Conclusions The caries prevalence of deciduous teeth in Haidian district of Beijing is relatively high.Targeted caries prevention and intervention strategies should be carried out according to the characteristics of teeth caries in children at different age stages.

Comparison of status and risk factors for caries among 5-year-old children in Guangzhou between 2008 and 2015

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

2018, 26(11):  1267-1270.  DOI: 10.11852/zgetbjzz2018-26-11-29

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Objective To study the prevalence and risk factors of caries among 5-year-old children in Guangzhou, in order to provide theoretical evidence for developing scientific and effective interventions.Methods Data of 5-year-old children in “Sampling survey on oral health epidemiology of children in Guangzhou” were collected and compared between 2008 and 2015. And the influencing factors of dental caries in 5-year-old children were analyzed.Results The prevalence of caries, mean dmft and filling rate in children aged 5 years in Guangzhou increased from 56.11%, 3.04 and 3.01% in 2008 to 76.78%, 5.47 and 4.05% in 2015, respectively. In both 2008 and 2015, caries prevalence and mean dmft in rural children (2008:78.89%, 5.33; 2015:86.05%, 6.91) were higher than those of urban children (2008:48.52%, 2.28; 2015:74.22%, 5.07). However, the filling rate of rural children (2008:1.04%; 2015:1.15%) were lower than that of urban children (2008:4.55%; 2015:5.14%). And there were no significant differences on caries prevalence, mean dmft and filling rate between boys and girls(all P>0.05). In 2015, 72.06% of caries occurred in the upper middle teeth and the first or second molars, and 70.31% of the total caries number of teeth occurred in 32.16% of the children. Multivariate conditional Logistic regression showed that habit of eating sweets before bedtime (OR=1.45, 95% CI:1.08~1.94), starting to brush teeth after 2 years old (OR=1.41,95% CI:1.06~1.86), lower education background of parents (OR=1.58,95% CI:1.19~2.11) and poor family economic status (OR=1.81, 95% CI:1.23~2.67) were risk factors for caries among children.Conclusion The prevalence of caries among 5-year-old children in Guangzhou is serious, showing an upward trend and low treatment rate. Therefore, the anti-caries and treatment measures should be adopted to reduce the incidence of caries in children.

Oral health status and evaluation of intervention effect among 472 preschool children

YUAN Lu-lu, ZHAO Hong, GAO Yu-qin

2018, 26(11):  1271-1276.  DOI: 10.11852/zgetbjzz2018-26-11-30

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Objective To investigate the oral health status of preschool children in Shenyang,to formulate the intervention project, and to evaluate the effect of intervention.Methods All children from two kindergartens with similar conditions and scale in Shenyang were selected as participants. The general situation questionnaire, childrens′oral health care knowledge demand questionnaire and the children′s oral health checklist were used as tools. The effect of intervention was evaluated in six months and one year after intervention.Results The average number of caries in preschool children among Shenyang was 2.82, and the prevalence rate of dental caries was 62.9%. After six months of intervention, the average number of caries and its prevalence increased in both groups. But the increase of dental caries prevalence in intervention group was significantly lower than that in control group (P＜0.05). After one year of intervention, the average number of caries and its prevalence decreased in both groups. And there was no statistically significant difference between one year and the baseline in the average number of caries and caries prevalence rate in intervention group (P＞0.05), but not in control group. In the process of intervention, the rate of caries treatment for children with caries was improved, but the difference between the two groups was not significant (P＞0.05).Conclusion The prevalence of dental caries in preschool children in Shenyang is relatively high,so early health education and intervention should be emphasized.